title: Cytologic features of primary signet ring cell carcinoma of the bladder: a case report.
abstract: BACKGROUND
  Signet ring cell carcinoma is a very rare subtype of adenocarcinoma of the urinary bladder. Urine cytology is a useful method for screening and followup of urinary bladder carcinoma.
  
  
  METHODS
  A 43-year-old woman was referred for evaluation of painless hematuria. Laboratory evaluation showed anemia, hematuria and elevated tumor marker levels. Pelvic computed tomography (CT) demonstrated diffuse wall thickening, and the chest CT suggested metastatic lesions in the lung and hepatic dome. Abdominal CT, esophagogastroduodenoscopy and colonoscopy revealed no evidence of malignancy in the gastrointestinal tract. Cystoscopy revealed very large masses in the anterior and posterior wall of the bladder. Bladder washings, urine cytology and biopsy demonstrated characteristic signet ring cells without foci of urothelial carcinoma or other lesions. Three months later, ascitic fluid was obtained; the results showed signet ring cells identical to those seen in the urine specimen.
  
  
  CONCLUSIONS
  Signet ring cell carcinoma of the urinary bladder can be diagnosed by urinary cytology and confirmed by cystoscopic biopsy.
authors.affiliation: Department of Pathology, Chonnam National University Medical School, and Genome Research Center for Hematopoietic Diseases, Chonnam National University Hwasun Hospital, Chonnam, Republic of Korea.
authors.forename: Sung Sun
authors.initials: SS
authors.lastname: Kim
authors.forename: Yoo Duk
authors.initials: YD
authors.lastname: Choi
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Nam
authors.forename: Dong Deuk
authors.initials: DD
authors.lastname: Kwon
authors.forename: Sang-Woo
authors.initials: SW
authors.lastname: Juhng
authors.forename: Chan
authors.initials: C
authors.lastname: Choi
mesh_terms: D000328:Adult; D001201:Ascites / Q000473:pathology; D001706:Biopsy; D018279:Carcinoma, Signet Ring Cell / Q000150:complications / Q000556:secondary*; D017809:Fatal Outcome; D005260:Female; D006417:Hematuria / Q000209:etiology / Q000473:pathology; D006801:Humans; D007507:Therapeutic Irrigation; D014057:Tomography, X-Ray Computed; D016482:Urinalysis; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000473:pathology*