title: Signet ring-like cells: no longer a "signature" of glandular differentiation.
abstract: The term "signet ring" is used to describe a cell with an eccentric nucleus that is compressed to the periphery of the cell by a large cytoplasmic vacuole or by a substance accumulated within the cytoplasm. In pathology, these cells have been traditionally associated with adenocarcinomas. We describe two cases of cutaneous tumors that contained signet ring-like cells. Because of the morphology of the cells and the fact that one patient had a past history of lung cancer, the possibility of metastatic adenocarcinoma was considered. Upon further investigation, the tumors proved to be a primary cutaneous squamous cell carcinoma and a basal cell carcinoma; surgical management was curative. Because signet ring changes may pose a diagnostic challenge, we review the various benign and malignant cutaneous lesions that have been reported to contain signet ring cells and we explore the possible causative mechanisms of this phenomenon.
authors.affiliation: Department of Medicine (Dermatology), University of California, San Diego, California, USA.
authors.forename: David N
authors.initials: DN
authors.lastname: Lortscher
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Satter
authors.forename: Laura S
authors.initials: LS
authors.lastname: Romero
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology* / Q000601:surgery; D018279:Carcinoma, Signet Ring Cell / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery