scholarly journals Signet Ring Cell Carcinoma Mimicking Gastric Gastrointestinal Stromal Tumor: A Case Report

2020 ◽  
Vol 13 (2) ◽  
pp. 538-543
Author(s):  
Jin Lee ◽  
Sung Jin Oh
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Gastric Carcinoma ◽  
Gastrointestinal Stromal Tumor ◽  
Cell Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Histologic Diagnosis ◽  
Signet Ring ◽  
Ring Cell

The presentation of submucosal gastric cancer, especially signet ring cell carcinoma, is rare. The submucosal tumor (SMT) is covered with normal mucosa, and confirmation is difficult through endoscopic biopsy; thus, histologic diagnosis is important to determine the appropriate treatment method. Here, we report a case of gastric signet ring cell carcinoma mimicking gastrointestinal stromal tumor (GIST). A 2-cm-sized SMT suspected of being a GIST on preoperative endoscopic ultrasonography and computed tomography was suspected to be cancerous during surgery. The frozen diagnosis of the resected mass (obtained via wedge resection) showed a carcinoma with signet ring feature, and additional frozen diagnosis of one enlarged lymph node revealed metastatic cancer. Therefore, subtotal gastrectomy with lymph node dissection was performed. This case report suggests that preoperative histologic diagnosis of high-risk SMT might be useful, although the tumor had typical features of GIST on preoperative imaging. Overall, if a tumor is suspected of being a gastric carcinoma during surgery and the differential diagnosis between gastric carcinoma and GIST is uncertain, a careful surgical approach should be considered to account for the possibility of adenocarcinoma.

Signet Ring Cell Carcinoma of the Extrahepatic Bile Duct: A Case Report

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S68-S69
Author(s):  
Nadia Hameed ◽  
Stephen Marbut
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Cell Carcinoma ◽  
Extrahepatic Bile Duct ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Signet Ring ◽  
Ring Cell

Abstract Introduction Signet ring cell carcinoma (SRCC) of the biliary system is extremely rare and its clinicopathological features and impact on prognosis are not well known. We report the extremely rare case of SRCC originating from the extrahepatic bile duct. Case Report We present a 76-year-old female who had elevated liver enzymes noted on routine laboratory test. Abdominal imaging revealed a polypoid mass within the central bile duct, located above the level of pancreatic head with proximal intrahepatic duct dilatation with no significant lymphadenopathy or ascites. Total bilirubin was normal, alanine transaminase level was 163 IU/L, and aspartate aminotransferase was 55 IU/L. The patient underwent common bile duct excision with cholecystectomy. The specimen showed a 3.3-cm centrally located tan polypoid lesion in the common bile duct with adjacent firm lymph node. Microscopic examination of the lesion revealed sheets of tumors cells with signet ring cell morphology underlying benign biliary epithelium. The lymph node was completely replaced by neoplastic cells. The neoplastic cells were diffusely positive for CDX2 and focally positive for CK7 and CK20. The histomorphology and immunophenotype are consistent with poorly differentiated adenocarcinoma with signet ring cell type. Conclusion SRCC of the extrahepatic bile duct is a histologically distinct entity classified by the World Health Organization, but it is very rare. To best of our knowledge, only five cases of SRCC of the extrahepatic bile duct have been reported in the English literature.

Cytology Detects Endobronchial Metastasis from Appendiceal Signet-Ring Cell Carcinoma in the Absence of Radiographic Lung Masses: A Case Report

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S44-S44
Author(s):  
B W Taylor ◽  
K Hummel ◽  
Y Xu
Keyword(s):  
Case Report ◽  
Respiratory Distress ◽  
Cell Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Signet Ring Cells ◽  
Endobronchial Metastasis ◽  
Signet Ring ◽  
Ring Cell ◽  
The Right

Abstract Introduction/Objective Endobronchial metastasis (EBM) is uncommon, with a reported prevalence of 2% in cases of non-lung primary malignancies. The most frequently observed carcinomas in EBM are from breast, colon, and renal origins. We present a rare case of endobronchial metastasis from a primary tumor of the appendix without lung masses by computed tomography (CT). Methods/Case Report An 83-year-old woman with signet-ring cell carcinoma of the appendix underwent right hemicolectomy and chemotherapy. Two years later, she returned with intractable nausea and vomiting, and respiratory distress. CT of the chest demonstrated diffuse bilateral pulmonary opacities without lung masses. CT of the abdomen showed peritoneal carcinomatosis. Cytology of ascitic fluid displayed metastasis of the patient’s known appendiceal tumor. Bronchoscopy found significant friable debris appearing to be tumor tissue and occluding multiple bronchioles in the right lung. A bronchoalveolar lavage (BAL) specimen from the right lung was sent for liquid-based cytology, which revealed a few atypical cells with eccentric nuclei and intracytoplasmic vacuoles, abundant macrophages, degenerated mixed inflammatory cells, and scattered bronchial epithelial cells. Cell block demonstrated signet-ring cells mimicking macrophages and infiltrating into small fragments of bronchiolar wall. The signet-ring cells were morphologically similar to those found in the ascitic fluid and the patient’s primary tumor, and were highlighted by mucicarmine stain and immunohistochemical stains for CDX-2 and CK20, but not CK7. Results (if a Case Study enter NA) N/A Conclusion Collectively, the findings supported the diagnosis of endobronchial metastasis of signet-ring cell carcinoma from the lower gastrointestinal tract, i.e. the patient’s known appendiceal primary. Our case demonstrates a rare endobronchial metastasis of a primary neoplasm of the appendix, an important diagnostic consideration when evaluating respiratory distress in patients with such cancer histories. We have described the significant role of BAL cytology to uncover endobronchial metastases without lung masses by CT, and illustrated the finding of signet-ring cells mimicking macrophages in a BAL cytology specimen.

scholarly journals Urticarial vasculitis as an initial manifestation of colonic carcinoma: a case report and review of the literature

Reumatismo ◽  
2018 ◽  
Vol 70 (4) ◽  
pp. 259-263 ◽  
Author(s):  
A.A. Younis
Keyword(s):  
Case Report ◽  
Cell Carcinoma ◽  
Leukocytoclastic Vasculitis ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
High Dose ◽  
Urticarial Vasculitis ◽  
Carcinoma Of The Colon ◽  
Signet Ring ◽  
Ring Cell

Cutaneous vasculitis may behave as a paraneoplastic syndrome. Paraneoplastic vasculitis as a phenomenon of colonic adenocarcinoma has been described in the literature. To the best of my knowledge, this is the first case report of urticarial vasculitis being an initial presentation of signet-ring cell carcinoma of the colon. I here report a case of 27-year-old woman who had rash, arthritis, and episodic bleeding per rectum. The rash was biopsy-proven to be leukocytoclastic vasculitis. There was only partial response to high-dose steroid, and rectal bleeding continued. Colonoscopy revealed a stenosing growth of sigmoid colon, which proved to be signet ring cell carcinoma of the colon. It is important to remain vigilant with regard to the association between leukocytoclastic vasculitis and malignancies.

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