Signet-Ring Cell Change Versus Signet-Ring Cell Carcinoma: A Comparative Analysis

Kim Wang*, David Weinrach, Aseem Lal, Srinidhi Musunuri, James Ramirez, Ozden Ozer, Pacita Keh, M. Sambasiva Rao

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Signet-ring cell change (SCC) is a nonneoplastic condition that morphologically simulates signet-ring cell carcinoma (SRCA). The few case reports on SCC have focused on morphologic characteristics in distinguishing benign from malignant. In biopsy specimens, however, SCC can be easily confused with SRCA, which often demonstrates innocuous cytologic features. The object of this study is twofold: 1) to report 14 additional cases of SCC, comparing their morphologic and phenotypic features with that of SRCA; and 2) to evaluate the incidence of SCC in pseudomembranous colitis. Paraffin sections of biopsy or resection specimens containing focal or extensive SCC and 5 cases of colonic SRCA were stained with hematoxylin and eosin, periodic-acid Schiff stain with and without diastase digestion, and by standard ABC immunoperoxidase procedure using antibodies to E-cadherin, p53, and Ki-67. Both cells in SCC and SRCA were strongly positive for neutral mucins. Cells in SCC were strongly positive for E-cadherin and negative for p53 and Ki-67. In contrast, cells in SRCA were strongly positive for p53, exhibited high proliferation, and demonstrated absent or weak positivity for E-cadherin. Although SCC is not well recognized in pseudomembranous colitis, the incidence is fairly high: 14 of 50 (28%) cases showed variable numbers of signet-ring cells. Extensive SCC, although rare, can occur in different clinical conditions and can be easily mistaken for SRCA. When in doubt, routine immunohistochemical stains such as p53, Ki-67, and E-cadherin can help to differentiate SCC from SRCA.

Original languageEnglish (US)
Pages (from-to)1429-1433
Number of pages5
JournalAmerican Journal of Surgical Pathology
Issue number11
StatePublished - Nov 2003


  • Cystic fibrosis
  • Pseudomembranous colitis
  • Signet-ring cell carcinoma
  • Signet-ring cells

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine


Dive into the research topics of 'Signet-Ring Cell Change Versus Signet-Ring Cell Carcinoma: A Comparative Analysis'. Together they form a unique fingerprint.

Cite this