Bladder, ureter & renal pelvis
Glandular neoplasms
Signet ring cell adenocarcinoma
Author: Nat Pernick, M.D.
Last author update: 1 December 2014
Last staff update: 18 November 2021
Copyright: 2003-2023, PathologyOutlines.com, Inc.
PubMed Search: Bladder signet ring cell adenocarcinoma
Table of Contents
Definition / general | Epidemiology | Clinical features | Treatment | Gross description | Microscopic (histologic) description | Positive stains | Differential diagnosisCite this page: Pernick N Signet ring cell adenocarcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bladdersignetringcell.html. Accessed September 21st, 2023.
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
Epidemiology
- Usually men, median age 58 years (Am J Clin Pathol 1991;95:13)
Clinical features
- Diffuse infiltration, similar to linitis plastica of stomach, makes resection for cure virtually impossible
- Very aggressive with poorer survival; however, presence of a few signet ring cells doesn’t affect the prognosis of a bladder adenocarcinoma (World J Urol 2012;30:777)
Treatment
- Cystectomy may be important for improved survival (Urol Int 2011;86:453)
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
- Cytokeratin; usually mucin but may not be prominent
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)
