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Signet-ring cells associated with pseudomembranous colitis
1Department of Pathology, Pennsylvania Hospital, PA 19107-6192, USA.
The American Journal of Surgical Pathology
|May 1, 1996
Summary
An 82-year-old man developed pseudomembranous colitis with toxic megacolon after antibiotic treatment for pneumonia. Signet-ring cells in the colon were initially mistaken for recurrent carcinoma but were correctly identified.
Area of Science:
- Gastroenterology
- Pathology
- Oncology
Background:
- Antibiotic therapy for pneumonia can precipitate Clostridium difficile infection, leading to pseudomembranous colitis and toxic megacolon.
- A history of colonic carcinoma increases the complexity of diagnosing gastrointestinal conditions.
Observation:
- An elderly male patient presented with pseudomembranous colitis and toxic megacolon post-antibiotic treatment.
- Endoscopic examination revealed characteristic pseudomembranes alongside unusual signet-ring cells within the colonic epithelium and crypts.
Findings:
- The presence of signet-ring cells, typically associated with adenocarcinoma, was noted in the superficial epithelium and crypts.
- These signet-ring cells were definitively identified as reactive changes secondary to pseudomembranous colitis, not recurrent colonic carcinoma.
Implications:
- Accurate differentiation between reactive signet-ring cells and neoplastic cells is crucial for appropriate patient management.
- This case highlights the importance of thorough clinical history and endoscopic evaluation to avoid misdiagnosis in complex gastrointestinal presentations.