title: Signet ring cell carcinoma of the non-ampullary duodenum: A case report.
abstract: We describe a case of signet ring cell carcinoma of the non-ampullary duodenum in an 86-year-old woman. Endoscopic examination revealed a fungating lesion (Borrmann classification; type 2) on the anterior wall of the descending duodenum (second part). Pylorus-preserving pancreaticoduodenectomy and lymphadenectomy were performed. The tumor (pT3 and pN0) was predominantly composed of signet ring cells, characterized by a central, optically clear, globoid droplet of cytoplasmic mucin with an eccentrically placed nucleus. The cells were positive for periodic acid Schiff with diastase and Alcian blue pH 2.5. On immunohistochemical examination, MUC-5AC, MUC-2 and CDX2 were diffusely positive, and MUC-6 was negative in the tumor cells, which consisted of mixed gastric foveolar and intestinal phenotypes. Cytokeratin 7 was focally positive, but cytokeratin 20 was negative. Nuclear staining of p53 was diffusely and weakly positive. Signet ring cell carcinoma occurring in the non-ampullary duodenum might derive from duodenal goblet cells with MUC-5AC expression.
authors: Department of Pathology, University of Yamanashi, Yamanashi, Japan. Electronic address: kuniom@yamanashi.ac.jp.
authors: Kunio
authors: K
authors: Mochizuki
authors: Department of Pathology, University of Yamanashi, Yamanashi, Japan.
authors: Tetsuo
authors: T
authors: Kondo
authors: Department of Pathology, University of Yamanashi, Yamanashi, Japan.
authors: Ippei
authors: I
authors: Tahara
authors: Department of Pathology, University of Yamanashi, Yamanashi, Japan.
authors: Tomohiro
authors: T
authors: Inoue
authors: Department of Pathology, University of Yamanashi, Yamanashi, Japan.
authors: Kazunari
authors: K
authors: Kasai
authors: Department of Pathology, University of Yamanashi, Yamanashi, Japan.
authors: Naoki
authors: N
authors: Oishi
authors: Department of Pathology, University of Yamanashi, Yamanashi, Japan.
authors: Tadao
authors: T
authors: Nakazawa
authors: Department of Pathology, University of Yamanashi, Yamanashi, Japan.
authors: Ryohei
authors: R
authors: Katoh
mesh_terms: D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D018279:Carcinoma, Signet Ring Cell / Q000378:metabolism*; D004379:Duodenal Neoplasms / Q000378:metabolism* / Q000473:pathology; D004386:Duodenum / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D010190:Pancreatic Neoplasms / Q000378:metabolism* / Q000473:pathology; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor
keywords: Duodenum; Immunohistochemistry; MUC-5AC; Non-ampullary; Signet ring cell carcinoma