Primary signet-ring cell carcinoma of lung

Signet ring cell carcinoma may arise in the stomach, colon, breast, bladder or prostate. It is a rare primary pulmonary tumour: most cases of signet-ring cell carcinoma in the lung are metastatic.

Histopathology

A large mucin droplet displaces the nucleus to the edge of the cell. To be classified as a signet-ring cell carcinoma, more than 30% of the tumour should show a signet-ring cell morphology. The signet ring cells may show a diffuse architecture or may form acinar structures. There are no reliable morphological features differentiating primary from metastatic signet ring cell carcinoma of the lung.

Immunohistochemistry with signet ring cell carcinomas of stomach, colon and breast for comparison:

 

lung

stomach

colon

breast

TTF-1

14/171, 2/22, 1/13, 6/64

0/51

0/51

0/51

villin

5/171

5/51

5/51

1/51

CDX-2

0/22

variably positive

positive

 

MUC2

0/22

variable

positive

 

MUC5AC

1/22

positive

variable

 

SP-A

1/22

negative

negative

 

CEA

9/94

 

 

 

GCDFP-15

0/64

 

 

 

ER

0/64

 

 

 

PR

0/64

 

 

 

CK7+/CK20+

1/171

2/51

0/51

0/51

CK7+/CK20-

16/171, 2/22, 3/64

2/51

0/51

5/51

CK7-/CK20-

3/64

0/51

0/51

0/51

CK7-/CK20+

0/171

1/51

5/51

0/51

Immunoreactivity of mucinous carcinoma of lung other than signet ring cell type is on another page.

Differential diagnosis

 

Prognosis

This is an aggressive tumour2,4.

References

1Merchant, S. H., Amin, M. B., Tamboli, P., Ro, J., Ordonez, N. G., Ayala, A. G., Czerniak, B. A., Ro, J. Y. Primary signet-ring cell carcinoma of lung: immunohistochemical study and comparison with non-pulmonary signet-ring cell carcinomas. Am J Surg Pathol 2001;25:1515-1519

2Rossi, G., B. Murer, et al. (2004). "Primary mucinous (so-called colloid) carcinomas of the lung: a clinicopathologic and immunohistochemical study with special reference to CDX-2 homeobox gene and MUC2 expression." Am J Surg Pathol 28(4): 442-52.

3Stenhouse, G., N. Fyfe, et al. (2004). "Thyroid transcription factor 1 in pulmonary adenocarcinoma." J Clin Pathol 57(4): 383-7.

4Castro, C. Y., C. A. Moran, et al. (2001). "Primary signet ring cell adenocarcinomas of the lung: a clinicopathological study of 15 cases." Histopathology 39(4): 397-401.

 

This page last revised 1.10.2004.

©SMUHT/PW Bishop