Elsevier

Pathology

Volume 34, Issue 1, 2002, Pages 51-56
Pathology

Intestinal epithelial lesions associated with signet ring cell carcinoma of the colon and small intestine

https://doi.org/10.1080/00313020120105642Get rights and content

Summary

Aims

The purpose of this study was to investigate the epithelial lesions associated with signet ring cell carcinoma (SRCC) of the colon and small intestine and the possible mechanism of tumour development.

Methods

Twenty-seven cases of adenocarcinoma with a signet ring cell (SRC) component of the colon and small intestine were divided into three groups depending on the association of the SRCC with: (1) epithelium without definite epithelial dysplasia, (2) adenoma, and (3) common type of adenocarcinoma (CTCA) with SRCC component occupying more than 50%, 30%, or less than 30% of the tumour.

Results

Most carcinomas were of T3 or T4 type, using the TNM standard staging system. The SRCC component was histopathologically similar in all groups. In group 1 (four cases, linitis plastica type), the overlying epithelium was normal or showed indefinite epithelial dysplasia and occasionally contained intra-epithelial SRCs. In groups 2 and 3 (two and 21 cases, respectively), seven cases contained multiple foci of intra-epithelial SRCs in areas separated from the invasive carcinoma. Transitional areas between SRCC and adenoma or CTCA were also identified. Immunostaining for p53 showed a varied extent of positive reactivity in 23 SRCC. The degree and the extent of reactivity appeared to increase with the stage of the carcinoma. Most intraepithelial SRCs were immunoreactive for p53. Linitis plastica SRCC was associated with extensive p53 reactivity of the ‘atypical’ and the adjacent ‘normal’ epithelium.

Conclusions

SRCC may arise from either CTCA, adenoma, ‘atypical’ epithelium or a combination of these epithelia. SRCC accounts for the bulk of carcinoma in each of these categories. In linitis plastica SRCC, positive reactivity for p53 is extensive in the adjacent ‘normal’ colonic epithelium and extends as far as 3 cm from the microscopically identified SRCC margin

References (16)

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Cited by (17)

  • Early signet ring cell carcinoma arising from colonic adenoma: The molecular profiling supports the adenoma-carcinoma sequence

    2016, Human Pathology
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    Two of these cases were described in peculiar clinicopathological settings: the first being assessed in a 6-year-old child [13] and the second being detected at the site of ureterosigmoidostomy after conversion to an ileal conduit [9]. Another 4 cases of SRCC arose within tubular or tubulovillous colonic adenoma in asymptomatic adult patients [10–12]. The authors of the last 3 cited works interpreted the signet ring cancer as de-differentiated progression of the adjacent high-grade adenoma.

  • Signet ring cell infiltration in tubular adenoma of ascending colon

    2004, Pathology Research and Practice
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    Although the general characteristics of SRCC have been well described, its relationship to other colorectal neoplasm has not yet been well established. To the best of our knowledge, only a few cases documenting foci of signet ring cell infiltration found within a colon adenoma have been reported [1,5,7,8,10,11]. We present the first case of signet ring cell infiltration without any foci of conventional adenocarcinoma in tubular adenoma in a patient who underwent surgery for colonic carinoma at a different site in the large bowel seven months earlier.

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