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Signet-ring cell change versus signet-ring cell carcinoma: a comparative analysis
Kim Wang1, David Weinrach, Aseem Lal
1Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
The American Journal of Surgical Pathology
|October 25, 2003
Summary
Signet-ring cell change (SCC) mimics cancer but is benign. Immunohistochemical stains like E-cadherin, p53, and Ki-67 help distinguish SCC from signet-ring cell carcinoma (SRCA), especially in pseudomembranous colitis.
Area of Science:
- Gastrointestinal Pathology
- Surgical Pathology
- Oncologic Pathology
Background:
- Signet-ring cell change (SCC) is a non-neoplastic condition that can be mistaken for signet-ring cell carcinoma (SRCA).
- Distinguishing between SCC and SRCA is crucial for accurate diagnosis and patient management.
- SCC is not widely recognized in conditions like pseudomembranous colitis.
Purpose of the Study:
- To report additional cases of SCC and compare their features with SRCA.
- To evaluate the incidence of SCC in pseudomembranous colitis.
- To identify reliable markers for differentiating SCC from SRCA.
Main Methods:
- Analysis of 14 SCC cases and 5 SRCA cases.
- Histochemical stains (H&E, PAS) and immunohistochemical stains (E-cadherin, p53, Ki-67).
- Comparison of morphologic and phenotypic features between SCC and SRCA.
Main Results:
- Both SCC and SRCA cells showed positivity for neutral mucins.
- SCC cells were positive for E-cadherin and negative for p53 and Ki-67.
- SRCA cells were positive for p53, showed high proliferation, and had weak/absent E-cadherin.
Conclusions:
- SCC can be mistaken for SRCA, particularly in biopsy specimens.
- SCC has a notable incidence (28%) in pseudomembranous colitis.
- Immunohistochemistry (p53, Ki-67, E-cadherin) is valuable for differentiating SCC from SRCA.