Pleomorphic lobular carcinoma in situ of the breast composed almost entirely of signet ring cells

Department of Pathology, Wilford Hall Medical Center, Lackland AFB, San Antonio, Texas 78236, USA.
Pathology International (Impact Factor: 1.69). 12/2006; 56(11):683-7. DOI: 10.1111/j.1440-1827.2006.02030.x
Source: PubMed


Some examples of lobular carcinoma in situ (LCIS) may be composed in part of signet ring cells. Such proliferations have been considered examples of pleomorphic LCIS based on pathological features of the more conventional component. However, the occurrence of LCIS composed entirely of signet ring cells is extraordinarily rare. This report describes an example of an in situ proliferation that was composed almost entirely (>95%) of signet ring cells, which was unassociated with an invasive carcinoma and which showed comedo-type necrosis. There was only focal lobulocentric distention by lesional cells, as is typical of classic LCIS. However, discrete, ductal-type cross-sectional profiles showed a purely intraepithelial proliferation of remarkably discohesive signet ring cells. The signet ring cells had intermediate-grade nuclear atypia, no significant mitotic activity and were positive for mucicarmine and PAS stains (the latter with and without diastase predigestion). The cells displayed marked immunoreactivity for high-molecular-weight keratin (stained by 34beta E12 antibody), MUC1, gross cystic disease fluid protein-15, cytokeratin 7 and were negative for cytokeratin 20, E-cadherin, progesterone receptor and HER2/neu. It is concluded that this is an example of a purely signet ring variant of pleomorphic LCIS.

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    • "SRCC is a mucin producing carcinoma, which shows aggressive lesions with a high risk of metastatic spread.[7] It can originate from both invasive lobular carcinoma and infiltrating ductal carcinoma, but more often from invasive lobular carcinomas.[268] The prevalence of SRCC features varies from 2% to 4.5% of the total breast carcinomas, but a pure form of SRCC is an extremely rare entity.[2345] "
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    ABSTRACT: Signet ring cell carcinoma (SRCC) of the breast is a rare tumor and it is classified by World Health Organization in 2003 classification under 'mucin producing carcinomas'. Pure form of SRCC breast is an extremely rare entity and very few cases have been reported in literature so far. We present a case of pure primary SRCC of the breast in a 70-year-old female, which was diagnosed on fine needle aspiration cytology. Cytological features generally show cellular smears with tumor cells showing eccentrically placed large, irregular nuclei showing indentations at places with cytoplasmic vacuoles. This case is being presented in view of its characteristic cytological features and its rarity.
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    ABSTRACT: Es wird über einen 71-jährigen männlichen Patienten berichtet, der 5 Monate vor Erstvorstellung in unserer Klinik eine diffuse livid-rötliche Verfärbung abdominal bemerkt hatte. In der feingeweblichen Untersuchung konnte eine Infiltration der Dermis durch Siegelringzellen gezeigt werden. Die daraufhin veranlasste Suche des Primärtumors zeigte ein lokal fortgeschrittenes Adenokarzinom (GIII–GIV) des Magens mit Schleimhautulzeration. Eine weitere Organmetastasierung konnte ausgeschlossen werden. Anhand des vorliegenden Falls wird der ungewöhnliche klinisch-diagnostische Verlauf bei einem Patienten mit einem Siegelringzellkarzinom des Magens aufgezeigt, das durch ein Erysipelas carcinomatosum der Abdominalhaut auffällig wurde.
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    ABSTRACT: A 71-year-old patient presented with diffuse and poorly circumscribed erythematous plaques of the abdominal skin, present for 5 months. Histology revealed a diffuse infiltration of the entire dermis with cytokeratin-positive signet-ring-cells. Subsequently, an extensive search for a primary adenocarcinoma uncovered a locally advanced signet-ring-cell gastric carcinoma. There were no metastases to other organs. This case shows the unusual clinical-diagnostic sequence of a patient with a signet-ring-cell-carcinoma of the stomach presenting with an erysipelas-like cutaneous metastasis of the abdominal skin.
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