Signet ring cell component predicts aggressive behaviour in colorectal mucinous adenocarcinoma

Goblet cell adenocarcinoma (GCA) is a rare amphicrine tumor and difficult to diagnose. GCA is traditionally found in the appendix, but extra-appendiceal GCA may be underestimated. Intestinal adenocarcinoma with signet ring cell component is also very rare, and some signet ring cell carcinomas are well cohesive, having some similar morphological features to GCAs. It is necessary to differentiate GCA from intestinal adenocarcinomas with cohesive signet ring cell component (IACSRCC). The goal of this study is to find occurrence of extra-appendiceal GCA and characterize the histological, immunohistochemical, transcriptional, and immune landscape of GCA. We collected 12 cases of GCAs and 10 IACSRCCs and reviewed the clinicopathologic characters of these cases. Immunohistochemical stains were performed with synaptophysin, chromogranin A, CD56, somatostatin receptor (SSTR) 2, and Ki-67. Whole transcriptome RNA-sequencing was performed, and data were used to analyze differential gene expression and predict immune cell infiltration levels in GCA and IACSRCC. RNA-sequencing data for colorectal adenocarcinoma were gathered from TCGA data portal. Of the 12 patients with GCA, there were 4 women and 8 men. There were three appendiceal cases and nine extra-appendiceal cases. GCAs were immunohistochemically different from IACSRCC. GCA also had different levels of B-cell and CD8+ T-cell infiltration compared to both colorectal adenocarcinoma and cohesive IACSRCCs. Differential gene expression analysis showed distinct gene expression patterns in GCA compared to colorectal adenocarcinoma, with a number of cancer-related differentially expressed genes, including upregulation of TMEM14A, GOLT1A, DSCC1, and HSD17B8, and downregulation of KCNQ1OT1 and MXRA5. GCA also had several differentially expressed genes compared to IACSRCCs, including upregulation of PRSS21, EPPIN, RPRM, TNFRSF12A, and BZRAP1, and downregulation of HIST1H2BE, TCN1, AC069363.1, RP11-538I12.2, and REG4. In summary, the number of extra-appendiceal GCA was underestimated in Chinese patients. GCA can be seen as a distinct morphological, immunohistochemical, transcriptomic, and immunological entity. The classic low-grade component of GCA and the immunoreactivity for neuroendocrine markers are the key points to diagnosing GCA.

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Metastatic signet ring cell adenocarcinoma of the bladder:

Canadian Urological Association Journal ◽

10.5489/cuaj.332 ◽

2013 ◽

Vol 6 (1) ◽

pp. 15 ◽

Cited By ~ 3

Author(s):

Jessica Singh ◽

Viktor Zherebitskiy ◽

David Grynspan ◽

Piotr Marek Czaykowski

Keyword(s):

Mucinous Adenocarcinoma ◽

Signet Ring Cell ◽

Response To Treatment ◽

Signet Ring Cell Adenocarcinoma ◽

Signet Ring ◽

Urologic Malignancy ◽

Ring Cell ◽

Cell Variant

Signet ring cell variant of mucinous adenocarcinoma of the urinarybladder is an exceptionally rare urologic malignancy, generally feltto be resistant to chemotherapy and radiotherapy. We describe acase of this malignancy with unusual sites of metastasis and anunexpectedly good response to treatment.

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Primary signet ring cell carcinoma of colon: Retrospective analysis of VACCR database.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.4_suppl.58 ◽

2011 ◽

Vol 29 (4_suppl) ◽

pp. 58-58 ◽

Cited By ~ 1

Author(s):

R. Thota ◽

T. Tashi ◽

W. Gonsalves ◽

V. Murukesan ◽

P. Townley ◽

...

Keyword(s):

Lymph Node ◽

Cell Carcinoma ◽

Mucinous Adenocarcinoma ◽

Cell Cancer ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Lymph Node Status ◽

Signet Ring ◽

Ring Cell ◽

Carcinoma Of Colon

58 Background: Signet ring cell carcinoma accounts for less than 1% of all colon cancers. We examined the clinical pathological features and prognosis of signet ring cell carcinoma of colon and compare it with mucinous and non-mucinous adenocarcinoma of colon. Methods: A total of 206 patients diagnosed with signet ring cell carcinoma from 1995 to 2009 were identified from the VA Central Cancer Registry (VACCR) database. Age, race, histology, grade, lymph node status, stage and type of treatment received data were collected. Results: Out of 206 patients, 173 (83.9%) were white, 31 (15%) were black, and 2 patients were listed as unknown. Median age of diagnosis was 67 years as compared to 70 years for both mucinous and non-mucinous adenocarcinoma of colon. Pathological T-stages were as follows: T1 = 2.9%, T2=5.3%, T3=33.9%, T4= 25.7%, and unknown 32%. Of the total, 22.3% were located in caecum, 21.8% in ascending colon, 15.5% in sigmoid colon, 7.7% in appendix and hepatic flexure of colon, 11.1% in transverse colon, 2.9% in splenic flexure and 4.4% in descending colon. 33.5% were lymph node positive, 34.6% were lymph node negative, and 31.8% were unknown. Histologically grade 3 (55.4%) was most commonly reported followed by grade 2 (7.3%), grade 1 (2.5%), grade 4 (1.9%)and in 33% grade was unknown. 41.3% patients received only surgery while 34% received surgery with adjuvant chemotherapy, 7.3% received chemotherapy alone and 7.8% patients received either chemotherapy, radiation or hormonal therapy alone, 9% did not receive any therapy. 1 year, 3 year and 5 year survivals for signet ring cell cancer compared to adeno carcinoma was 60% vs 80%, 33% vs 60%, and 24% vs 47% respectively. Median survival of signet ring cell carcinoma compared to mucinous and non mucinous adenocarcinoma was 19 months, 48 months and 62 months respectively. Conclusions: Signet ring cell carcinoma of colon has poor survival rates than the other histological subtypes. Signet ring cell carcinoma presents at an earlier age, higher tumor grade and advanced stage at diagnosis when compared to mucinous and non-mucinous adenocarcinoma of colon. Due to rarity of this disease further multi-institute studies are required for in-depth understanding and analysis of this disease. No significant financial relationships to disclose.

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Higher incidence of EGFR exon 19 deletion in younger (age 40 or younger) patients with adenocarcinoma of the lung.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.7044 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 7044-7044

Author(s):

Eri Sugiyama ◽

Koichi Goto ◽

Genichiro Ishii ◽

Shigeki Umemura ◽

Kiyotaka Yoh ◽

...

Keyword(s):

Elderly Patients ◽

Lung Adenocarcinoma ◽

Signet Ring Cell ◽

Egfr Mutations ◽

Cell Component ◽

Younger Patients ◽

Signet Ring ◽

Exon 19 Deletion ◽

Ring Cell ◽

Exon 19

7044 Background: The proportion of younger patients (≤ 40 years) with lung cancer is reported to be 2-5%. The most frequent histologic type of them is adenocarcinoma, however little is known about the pathological and molecular characteristics of younger patients with lung adenocarcinoma. Methods: Between July 1992 and April 2011, a total of 7443 patients were diagnosed as lung cancer in National Cancer Center Hospital East and 165 patients of whom (2.2%) who were 40 years or younger were identified. Among them, 44 patients with adenocarcinoma who underwent surgical resection were selected for this study. In addition, 185 elderly patients with > 40 years who underwent surgical resection matching gender and smoking status were selected as a control group. Histological predominant growth pattern and any coexisting variant pattern, the status of EGFR mutations were compared between these two groups. Results: The median age in ≤ 40 years patients was 37 years (range, 21 to 40 years) and that in elderly patients was 68 years (range, 42 to 83 years). Between these two groups, there were no significant differences in the distribution of histological predominant growth patterns (lepidic; 31.8% vs. 26.5%, papillary; 34.1% vs. 37.3%, acinar; 9.1% vs. 16.2%, and solid; 25.0% vs. 20.0%, p=0.78) and the incidence of EGFR mutations (40.9% vs. 45.9%; p=0.55). However, signet-ring cell component were significantly found in the younger patients than elderly (11.4% vs. 0%; p<0.01). The incidence of EGFR exon 19 deletion was significantly higher in younger patients than elderly, in contrast, that of EGFR exon 21 L858R was significantly higher in elderly patients (exon 19 del; 31.7% vs. 18.9%, L858R; 4.6% vs. 25.4%, p=0.0091). Three of 17 adenocarcinomas (17.7%) with EGFR-wild type in younger patients showed positive for ALK translocation. Conclusions: Younger patients with lung adenocarcinoma showed significantly higher proportion of EGFR exon 19 deletion genotype and containing histologically signet-ring cell component comparing with elderly patients. EGFR exon 19 deletion genotype may be related to pathogenesis of lung adenocarcinoma in younger patients.

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Acantholytic squamous cell carcinoma of the lung showing significant signet ring cell component

Histopathology ◽

10.1111/his.12762 ◽

2015 ◽

Vol 68 (3) ◽

pp. 463-465 ◽

Cited By ~ 3

Author(s):

Heae Surng Park ◽

Sungsoo Lee

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Signet Ring Cell ◽

Cell Component ◽

Signet Ring ◽

Ring Cell ◽

Acantholytic Squamous Cell Carcinoma

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Primary mucinous adenocarcinoma of the bladder with signet-ring cells: case report

Sao Paulo Medical Journal ◽

10.1590/s1516-31802007000500011 ◽

2007 ◽

Vol 125 (5) ◽

pp. 297-299 ◽

Cited By ~ 4

Author(s):

Marcelo Lorenzi Marques ◽

Gabriel Salum D'Alessandro ◽

Daher Cezar Chade ◽

Valéria Pereira Lanzoni ◽

Samuel Saiovici ◽

...

Keyword(s):

Case Report ◽

Mucinous Adenocarcinoma ◽

Rare Case ◽

Bladder Tumor ◽

Colorectal Adenocarcinoma ◽

Signet Ring Cell ◽

Signet Ring Cells ◽

Signet Ring ◽

Ring Cell ◽

Primary Bladder

CONTEXT: Primary adenocarcinomas of the bladder are uncommon and usually occur by contiguity with or hematogenic dissemination of other adenocarcinomas such as colorectal, prostate and gynecological tract carcinomas. Mucinous and signet-ring cell histological patterns are even rarer and it is often difficult to morphologically distinguish them from metastatic colorectal adenocarcinoma. CASE REPORT: We present and discuss a rare case of primary mucinous adenocarcinoma of the bladder with signet-ring cells in a 57-year-old male patient. Other primary sites for the tumor had been excluded and, in the absence of digestive tract tumor and for confirmation that it was a primary bladder tumor, an immunohistochemistry study was performed.

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