Signet Ring Cell Carcinoma in Urine Cytology: Cytomorphologic Findings and Differential Diagnosis

Background: Signet ring carcinoma is an exceedingly rare and aggressive variant of primary bladder carcinoma. The cytomorphologic features of this rare entity in urinary specimens have not been well characterized. Methods: Twenty-seven cases of signet ring cell carcinoma of the urinary bladder were...

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Veröffentlicht in:Acta cytologica 2012-01, Vol.56 (2), p.177-182
Hauptverfasser: Guan, Hui, Tatsas, Armanda D., Ali, Syed Z.
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Tatsas, Armanda D.
Ali, Syed Z.
description Background: Signet ring carcinoma is an exceedingly rare and aggressive variant of primary bladder carcinoma. The cytomorphologic features of this rare entity in urinary specimens have not been well characterized. Methods: Twenty-seven cases of signet ring cell carcinoma of the urinary bladder were identified from the pathology archives of The Johns Hopkins Hospital (1989–2011). Of these, 6 cases with prior urinary cytology specimens were studied. Results: There were 5 males and 1 female, with a mean age of 62 years. The presenting complaints included hematuria with or without symptoms of bladder irritation. Histopathologically, there were 5 cases of primary bladder carcinoma and 1 case of metastatic colonic signet ring cell carcinoma. The salient cytomorphologic features included scattered malignant epithelial cells, displaying distinct cell borders, abundant cytoplasm with a single large, discrete mucin vacuole, and eccentric irregular nuclei with prominent nucleoli. Primary adenocarcinoma additionally revealed a few intact malignant glandular epithelial fragments. Metastatic colonic signet ring cell carcinoma displayed predominantly singly dispersed malignant cells with eccentrically placed, oval nuclei with occasional small nucleoli and a moderate amount of vacuolated cytoplasm. Conclusion: Signet ring cell carcinomas are rarely encountered in urinary cytology. The differential diagnosis includes distended histiocytes or degenerated urothelial cells, primary signet ring cell carcinoma, and metastatic adenocarcinoma.
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The cytomorphologic features of this rare entity in urinary specimens have not been well characterized. Methods: Twenty-seven cases of signet ring cell carcinoma of the urinary bladder were identified from the pathology archives of The Johns Hopkins Hospital (1989–2011). Of these, 6 cases with prior urinary cytology specimens were studied. Results: There were 5 males and 1 female, with a mean age of 62 years. The presenting complaints included hematuria with or without symptoms of bladder irritation. Histopathologically, there were 5 cases of primary bladder carcinoma and 1 case of metastatic colonic signet ring cell carcinoma. The salient cytomorphologic features included scattered malignant epithelial cells, displaying distinct cell borders, abundant cytoplasm with a single large, discrete mucin vacuole, and eccentric irregular nuclei with prominent nucleoli. Primary adenocarcinoma additionally revealed a few intact malignant glandular epithelial fragments. Metastatic colonic signet ring cell carcinoma displayed predominantly singly dispersed malignant cells with eccentrically placed, oval nuclei with occasional small nucleoli and a moderate amount of vacuolated cytoplasm. Conclusion: Signet ring cell carcinomas are rarely encountered in urinary cytology. 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The cytomorphologic features of this rare entity in urinary specimens have not been well characterized. Methods: Twenty-seven cases of signet ring cell carcinoma of the urinary bladder were identified from the pathology archives of The Johns Hopkins Hospital (1989–2011). Of these, 6 cases with prior urinary cytology specimens were studied. Results: There were 5 males and 1 female, with a mean age of 62 years. The presenting complaints included hematuria with or without symptoms of bladder irritation. Histopathologically, there were 5 cases of primary bladder carcinoma and 1 case of metastatic colonic signet ring cell carcinoma. The salient cytomorphologic features included scattered malignant epithelial cells, displaying distinct cell borders, abundant cytoplasm with a single large, discrete mucin vacuole, and eccentric irregular nuclei with prominent nucleoli. Primary adenocarcinoma additionally revealed a few intact malignant glandular epithelial fragments. Metastatic colonic signet ring cell carcinoma displayed predominantly singly dispersed malignant cells with eccentrically placed, oval nuclei with occasional small nucleoli and a moderate amount of vacuolated cytoplasm. Conclusion: Signet ring cell carcinomas are rarely encountered in urinary cytology. The differential diagnosis includes distended histiocytes or degenerated urothelial cells, primary signet ring cell carcinoma, and metastatic adenocarcinoma.</description><subject>Adenocarcinoma - diagnosis</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - secondary</subject><subject>Aged</subject><subject>Carcinoma, Signet Ring Cell - diagnosis</subject><subject>Carcinoma, Signet Ring Cell - pathology</subject><subject>Carcinoma, Signet Ring Cell - secondary</subject><subject>Cell Nucleus - pathology</subject><subject>Colonic Neoplasms - pathology</subject><subject>Cytoplasm - pathology</subject><subject>Female</subject><subject>Histiocytes - pathology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nongynecologic Cytopathology</subject><subject>Retrospective Studies</subject><subject>Urinary Bladder - pathology</subject><subject>Urinary Bladder Neoplasms - diagnosis</subject><subject>Urinary Bladder Neoplasms - pathology</subject><subject>Urothelium - pathology</subject><issn>0001-5547</issn><issn>1938-2650</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kL1PwzAQxS0EoqUwsCPkDTEE7Dh2UjYUKCBVQgI6R45zDobELnY69L_HpaXTfej3nu4eQueU3FDKp7eEEMY4pcUBGtMpK5JUcHKIxnFPE86zfIROQvjaUEKwYzRKU5YXpKBjJN9Na2HAb8a2uISuw6X0yljXS2wsXnhjAZfrwXWuXd_9db3zy8_NbBSeGdtEZcDSNvjBaA0e7GBkFwfZWhdMOEVHWnYBznZ1ghazx4_yOZm_Pr2U9_NEMcKHRAvNmWQ1ybgqoGFEsxoynYuMNqSWSqaFBh2vrumU1hkXWUpVLqCGhmtOBZugq63v0rufFYSh6k1Q8SNpwa1CNU0F5Wkhskheb0nlXQgedLX0ppd-XVFSbQKt9oFG9nLnuqp7aPbkf4IRuNgC39K34PfATv8LOYx5qA</recordid><startdate>20120101</startdate><enddate>20120101</enddate><creator>Guan, Hui</creator><creator>Tatsas, Armanda D.</creator><creator>Ali, Syed Z.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120101</creationdate><title>Signet Ring Cell Carcinoma in Urine Cytology: Cytomorphologic Findings and Differential Diagnosis</title><author>Guan, Hui ; Tatsas, Armanda D. ; Ali, Syed Z.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c305t-f6f53a3b045c8ed30f3be4f7641d0baca28fef780b191b456421c76ebed5f5163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adenocarcinoma - diagnosis</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - secondary</topic><topic>Aged</topic><topic>Carcinoma, Signet Ring Cell - diagnosis</topic><topic>Carcinoma, Signet Ring Cell - pathology</topic><topic>Carcinoma, Signet Ring Cell - secondary</topic><topic>Cell Nucleus - pathology</topic><topic>Colonic Neoplasms - pathology</topic><topic>Cytoplasm - pathology</topic><topic>Female</topic><topic>Histiocytes - pathology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nongynecologic Cytopathology</topic><topic>Retrospective Studies</topic><topic>Urinary Bladder - pathology</topic><topic>Urinary Bladder Neoplasms - diagnosis</topic><topic>Urinary Bladder Neoplasms - pathology</topic><topic>Urothelium - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guan, Hui</creatorcontrib><creatorcontrib>Tatsas, Armanda D.</creatorcontrib><creatorcontrib>Ali, Syed Z.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Acta cytologica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guan, Hui</au><au>Tatsas, Armanda D.</au><au>Ali, Syed Z.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Signet Ring Cell Carcinoma in Urine Cytology: Cytomorphologic Findings and Differential Diagnosis</atitle><jtitle>Acta cytologica</jtitle><addtitle>Acta Cytologica</addtitle><date>2012-01-01</date><risdate>2012</risdate><volume>56</volume><issue>2</issue><spage>177</spage><epage>182</epage><pages>177-182</pages><issn>0001-5547</issn><eissn>1938-2650</eissn><abstract>Background: Signet ring carcinoma is an exceedingly rare and aggressive variant of primary bladder carcinoma. The cytomorphologic features of this rare entity in urinary specimens have not been well characterized. Methods: Twenty-seven cases of signet ring cell carcinoma of the urinary bladder were identified from the pathology archives of The Johns Hopkins Hospital (1989–2011). Of these, 6 cases with prior urinary cytology specimens were studied. Results: There were 5 males and 1 female, with a mean age of 62 years. The presenting complaints included hematuria with or without symptoms of bladder irritation. Histopathologically, there were 5 cases of primary bladder carcinoma and 1 case of metastatic colonic signet ring cell carcinoma. The salient cytomorphologic features included scattered malignant epithelial cells, displaying distinct cell borders, abundant cytoplasm with a single large, discrete mucin vacuole, and eccentric irregular nuclei with prominent nucleoli. Primary adenocarcinoma additionally revealed a few intact malignant glandular epithelial fragments. 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subjects Adenocarcinoma - diagnosis
Adenocarcinoma - pathology
Adenocarcinoma - secondary
Aged
Carcinoma, Signet Ring Cell - diagnosis
Carcinoma, Signet Ring Cell - pathology
Carcinoma, Signet Ring Cell - secondary
Cell Nucleus - pathology
Colonic Neoplasms - pathology
Cytoplasm - pathology
Female
Histiocytes - pathology
Humans
Male
Middle Aged
Nongynecologic Cytopathology
Retrospective Studies
Urinary Bladder - pathology
Urinary Bladder Neoplasms - diagnosis
Urinary Bladder Neoplasms - pathology
Urothelium - pathology
title Signet Ring Cell Carcinoma in Urine Cytology: Cytomorphologic Findings and Differential Diagnosis
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