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Breast malignant, males, children

Carcinoma subtypes

Signet ring cell variant of invasive ductal carcinoma


Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 4 November 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

Definition
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● Ductal carcinoma with cells resembling gastric carcinoma due to acidic mucin that fills cytoplasm and displaces nucleus
● Excludes cases with lobular features (signet ring variant of lobular carcinoma)

Case reports
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● 40 year old woman presenting with cystic pelvic mass (Acta Chir Belg 2005;105:224)
● 52 year old woman with associated invasive ductal carcinoma (Breast Cancer 1999;6:223)
● 54 year old woman with uterine metastases (J Obstet Gynaecol Res 2012;38:948)
● 68 year old woman (Pathol Int 2000;50:67)
● 73 year old woman with invasive ductal carcinoma with signet ring cell and mucinous carcinoma components (Diagn Cytopathol 2007;35:171)
● 74 year old woman with metastatic breast cancer to stomach resembling early gastric cancer (Case Rep Oncol 2010;3:142)
● Ductal type signet ring cell carcinoma of breast (Pathology 2011;43:282)

Micro description
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● Mucin fills cytoplasm and displaces nucleus
● Usually coexists with invasive ductal NOS
● High nuclear grade; DCIS may be present, but no lobular features (by definition)

Micro images
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Breast metastasis to stomach

Cytology description
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● Look for signet ring cells if plasmacytoid cells are identified
● Favor ductal carcinoma if hypercellular, single signet ring cells, high nuclear grade and tubule formation
● Favor lobular carcinoma if hypocellular, single signet ring cells and mild / moderate nuclear grade (Cytopathology 2009;20:321)

Differential diagnosis
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Signet ring variant of lobular carcinoma: usually classic lobular component present, no DCIS, ER+ and E-cadherin negative
● Metastatic GI signet ring carcinoma: history, no DCIS, CDX2+ and ER- (Am J Clin Pathol 2004;121:884, ISRN Obstet Gynecol 2011;2011:426150)

End of Breast malignant, males, children > Carcinoma subtypes > Signet ring cell variant of invasive ductal carcinoma


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