Primary mucinous adenocarcinoma of the lung with signet-ring cells: A histochemical comparison with signet-ring cell carcinomas of other sites

Kish, Janet K.; Ro, Jae Y.; Ayala, Alberto G.; McMurtrey, Marion J.

doi:10.1016/0046-8177(89)90229-3

Cited by 79 publications

(46 citation statements)

References 9 publications

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“…They, and others, have also noted that mucinous bronchioloalveolar adenocarcinoma and signet ring adenocarcinoma of lung fail to express CDX2 with the former showing frequent expression of CK20 but absence of TTF-1. 6,8,19,[27][28][29]31,32 These studies suggest that the expression of enteric markers is related to mucinous differentiation by neoplastic cells particularly goblet cells. Why goblet cell differentiation in goblet cell type colloid carcinoma should have a different phenotype from mucinous variants of bronchio alveolar carcinoma or pulmonary intestinal-type adenocarcinoma is unclear.…”

Section: Discussionmentioning

confidence: 91%

“…2,3 Within this group are mucinous cystic tumors including mucinous cystadenocarcinoma, mucinous (colloid) carcinoma, mucinous variants of bronchioloalveolar carcinoma, and signet ring cell carcinoma. 2,[4][5][6][7][8][9][10][11] The histologic and differentiation characteristics of these tumors overlap with gastrointestinal malignancies, especially colorectal carcinoma, including variants initially reported as 'enteric' carcinoma of the lung. [12][13][14][15] This current study reports six cases of intestinal-type adenocarcinoma of lung, morphologically similar to high-grade sinonasal adenocarcinoma of the intestinal type, and examines the differential expression of recently characterized immunohistochemical markers associated with colorectal and lung tumors including CDX-2, TTF-1, MUC1, MUC2, MUC5, cytokeratin 7 (CK7), and cytokeratin 20 (CK20).…”

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confidence: 99%

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Pulmonary intestinal-type adenocarcinoma does not show enteric differentiation by immunohistochemical study

Yousem

2005

Modern Pathology

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Six cases of an unusual variant of primary pulmonary adenocarcinoma resembling colorectal and sinonasal adenocarcinoma are presented. Pulmonary intestinal-type adenocarcinoma occurs in elderly Caucasians and is associated with a histology characteristic of colorectal/enteric adenocarcinoma: a garland-like architecture with a 'gland in gland' periphery, central 'dirty' necrosis, and elongated stratified columnar cells, lacking significant goblet or signet ring differentiation. While a resemblance to intestinal adenocarcinoma by light microscopy is present, immunohistochemical studies comparing these carcinomas with metastatic colorectal adenocarcinoma clearly show a respiratory phenotype with the neoplastic cells expressing thyroid transcription factor-1 and cytokeratin 7 to the exclusion of cytokeratin 20, and failing to express CDX-2. Stains for a variety of epithelial mucins (MUC1, MUC2, MUC5AC) also support this observation. The differential diagnosis with other pulmonary adenocarcinomas, especially those with mucinous differentiation, is discussed.

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Section: Discussionmentioning

confidence: 91%

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confidence: 99%

Pulmonary intestinal-type adenocarcinoma does not show enteric differentiation by immunohistochemical study

Yousem

2005

Modern Pathology

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“…1 Signet-ring cell carcinomas can arise in a wide variety of organs, including lung, [2][3][4][5][6] stomach, 7,8 colon, [8][9][10] breast, 8,11,12 urinary bladder, [13][14][15][16][17] pancreas, 18 salivary glands, 19 and prostate. [20][21][22][23][24][25][26][27][28] The signet-ring configuration seen in adenocarcinomas has traditionally been associated with the accumulation of large amounts of intracytoplasmic mucin.…”

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Mesothelioma with signet-ring cell features: report of 23 cases

Ordóñez

2013

Modern Pathology

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Signet-ring cell mesothelioma is uncommon and only two case reports have been published on this mesothelioma variant, both of which were initially misdiagnosed as signet-ring cell carcinoma. Herein are reported 23 signet-ring cell mesotheliomas that were investigated by immunohistochemistry, 12 of which were also studied by electron microscopy. Twenty-one of the cases originated in the pleura and two in the peritoneum. For comparison purposes and in order to determine the value of these techniques in the differential diagnosis of these tumors, seven cases of signet-ring cell lung adenocarcinoma were also studied. All signetring cell mesotheliomas were positive for calretinin, keratin 5/6, keratin 7, and mesothelin, 93% for podoplanin, and 91% for WT1; whereas, none reacted for MOC-31, CEA, TAG-72, CD15, TTF-1, napsin A, or CDX2. Among signet-ring cell lung adenocarcinomas, 100% were positive for keratin 7, CEA, and napsin A, 86% each for TTF-1 and TAG-72, 71% for CD15, and 14% for mesothelin, while all were negative for calretinin, keratin 5/6, WT1, podoplanin, and CDX2. After analyzing the results, it is concluded that the panels of markers used in the differential diagnosis of this mesothelioma variant should include those markers that are usually expressed in mesotheliomas (eg, calretinin, keratin 5/6, WT1, and podoplanin), broad-spectrum carcinoma markers that are frequently expressed in adenocarcinomas regardless of their site of origin (eg, MOC-31 and CEA), and organ-associated markers (eg, TTF-1 and napsin A for lung), which allow the site of origin of a metastatic adenocarcinoma to be established. Electron microscopy can be very useful as it permits the identification of characteristic ultrastructural mesothelioma and adenocarcinoma markers, and it also allows a better understanding of the morphologic features seen on routine light microscopy. Pathologists should be aware of this mesothelioma subtype as it can potentially be confused with other tumors that exhibit signet-ring features. Modern Pathology (2013) 26, 370-384; doi:10.1038/modpathol.2012.172; published online 5 October 2012Keywords: electron microscopy; immunohistochemistry; signet-ring cell carcinoma; signet-ring cell mesotheliomaThe finding of occasional vacuolated cells exhibiting signet-ring-like morphology is not rare in mesotheliomas; however, epithelioid mesotheliomas having a large number of such cells are relatively uncommon and have been subclassified as signet-ring cell mesotheliomas. 1 Signet-ring cell carcinomas can arise in a wide variety of organs, including lung, 2-6 stomach, 7,8 colon, 8-10 breast, 8,11,12 urinary bladder, 13-17 pancreas, 18 salivary glands, 19 and prostate. [20][21][22][23][24][25][26][27][28] The signet-ring configuration seen in adenocarcinomas has traditionally been associated with the accumulation of large amounts of intracytoplasmic mucin. It can also occur as a result of the formation of a true intracytoplasmic lumen with displacement of the nucleus toward the periphery of the cell, in which case, spe...

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“…İlk olarak Kish ve ark. [6] tarafın-dan 1989'da tanımlanan bu histopatolojik alt tipin akciğer adenokarsinomunda kötü prognoz belirteci olduğu kabul edilmektedir [7].…”

Section: Discussionunclassified

A Case of Primary Signet Ring Cell Carcinoma of Lung

Karatasli¹,

Şen²,

Canpolat³

et al. 2012

Tur Toraks Der

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Signet ring cell carcinoma, a sub-type of adenocarcinoma, is generally metastatic when seen in the lung. A rarely seen case of bronchoscopically diagnosed primary signet ring cell carcinoma of lung is presented. We aimed to point out the importance of differential diagnosis of primary and metastatic tumors, since they require different clinical approaches.(Tur Toraks Der 2012; 13: 74-5) GİRİŞTüm dünyada kanser mortalite ve morbiditesinin en önemli nedeni akciğerin epitelyal tümörleridir. En sık görülen histopatolojik tip olan adenokarsinoma, bez oluşumu ile karakterizedir. Taşlı yüzük hücreli karsinoma (TYHK), akciğer adenokarsinomunun ender görülen bir alt tipidir [1]. Akciğerde pür TYHK olarak görülmesi oldukça nadirdir; tümörün TYHK bileşeni arttıkça prognozun kötüleştiği bildirilmiştir [2,3].Hücre içi müsin birikimiyle seyreden TYHK mide, kolon, meme, mesane ve prostat gibi çeşitli organlardan köken alabilir. Agresif seyirli bu kötü diferansiye tümör, akciğerde görüldüğünde sıklıkla metastazla gelmiştir. Primer akciğer tümörü olarak insidansı oldukça düşük olup Tsuta ve ark.'nın [4] çalışmasında %1.5 olarak bildirilmiştir. Akciğerin primer ve metastatik TYHK olgularında prognostik özellikler ve uygulanan tedavi planları birbirinden oldukça farklıdır. Nadir görülen bu olguyu sunarken primer ve metastatik TYHK ayırıcı tanısının önemini vurgulamayı amaçladık.

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Primary mucinous adenocarcinoma of the lung with signet-ring cells: A histochemical comparison with signet-ring cell carcinomas of other sites

Cited by 79 publications

References 9 publications

Pulmonary intestinal-type adenocarcinoma does not show enteric differentiation by immunohistochemical study

Pulmonary intestinal-type adenocarcinoma does not show enteric differentiation by immunohistochemical study

Mesothelioma with signet-ring cell features: report of 23 cases

A Case of Primary Signet Ring Cell Carcinoma of Lung

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