title: Nonneoplastic signet-ring cells in the gallbladder and uterine cervix. A potential source of overdiagnosis.
abstract: We describe 3 cases of nonneoplastic signet-ring cell change in ulcerated mucosa, 2 of them in the gallbladder and 1 in an endocervical polyp. In the gallbladder cases, there were focal collections of signet-ring cells both on the mucosal surface and within the lumen of tubules, whereas in the endocervical polyp, the signet-ring cell aggregates were entirely confined to the mucosal surface. In all 3 cases, the signet-ring cells were positive for Mayer's mucicarmine and immunoreactive for keratin AE1/AE3. The lack of nuclear atypicality, the arrangement in superficial and intraluminal nests, and the admixture with histiocytes and other inflammatory cells are in keeping with the interpretation that the signet-ring cells are disrupted mucosal goblet cells exhibiting hyperplastic and degenerative changes. A review of the literature disclosed only other 2 previously reported cases of benign signet-ring cell changes in the gallbladder and none--to the best of our knowledge--in an endocervical polyp. Awareness of this phenomenon is of importance to avoid a potential overdiagnosis of signet-ring cell adenocarcinoma.
authors.affiliation: Section of Pathologic Anatomy M. Malpighi, Bellaria Hospital, University of Bologna, 40139 Bologna, Italy. moira79@gmail.com
authors.forename: Moira
authors.initials: M
authors.lastname: Ragazzi
authors.forename: Carolina
authors.initials: C
authors.lastname: Carbonara
authors.forename: Juan
authors.initials: J
authors.lastname: Rosai
mesh_terms: D000328:Adult; D018279:Carcinoma, Signet Ring Cell / Q000175:diagnosis*; D002584:Cervix Uteri / Q000473:pathology*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control*; D005260:Female; D005705:Gallbladder Diseases / Q000473:pathology*; D006801:Humans; D006965:Hyperplasia; D007633:Keratins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D011127:Polyps / Q000473:pathology* / Q000601:surgery; D014456:Ulcer / Q000473:pathology; D002577:Uterine Cervical Diseases / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D007633:Keratins