Signet ring cell adenocarcinoma

Author: Nat Pernick, M.D. (see Authors page)

Revised: 1 August 2016, last major update December 2014

Copyright: (c) 2003-2016,, Inc.

PubMed Search: Bladder signet ring cell adenocarcinoma
Cite this page: Signet ring cell adenocarcinoma. website. Accessed October 20th, 2018.
Definition / general
  • Uncommon tumor with signet ring type cells with intracytoplasmic mucin
  • Recommended to limit diagnosis to cases with 25% or more signet ring tumor cells
Clinical features
  • Diffuse infiltration, similar to linitis plastica of stomach, makes resection for cure virtually impossible
  • Very aggressive with poorer survival (World J Urol 2012;30:777); however, presence of a few signet ring cells doesn’t affect the prognosis of a bladder adenocarcinoma
Gross description
  • Usually nonurachal
  • May lack mucosal involvement
  • Diffusely infiltrative
Microscopic (histologic) description
  • Signet ring type cells with intracytoplasmic mucin, resembling lobular carcinoma of breast but larger
  • May have monocytoid cells with central nuclei
  • Urothelial abnormalities may be difficult to find
  • No abundant extracellular mucin
Positive stains
Differential diagnosis
  • Direct extension from prostatic or rectal adenocarcinoma
  • Metastasis from stomach, breast or other organs
  • Nodular histiocytic hyperplasia: rare, one case in lamina propria of bladder, may have mild atypia and mitoses; strong CD68+, keratin- (Am J Surg Pathol 1998;22:285)