Bladder, ureter & renal pelvis

Glandular neoplasms

Signet ring cell adenocarcinoma

Topic Completed: 1 December 2014

Minor changes: 18 November 2021

Copyright: 2003-2021,, Inc.

PubMed Search: Bladder signet ring cell adenocarcinoma

Nat Pernick, M.D.
Page views in 2020: 1,420
Page views in 2021 to date: 1,410
Cite this page: Pernick N Signet ring cell adenocarcinoma. website. Accessed December 7th, 2021.
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; however, presence of a few signet ring cells doesn’t affect the prognosis of a bladder adenocarcinoma (World J Urol 2012;30:777)
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)
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