Signet ring cells of stromal derivation in the uterine cervix secondary to cauterisation: report of a previously undescribed phenomenon.

AIMS

To describe the occurrence of signet ring cells of stromal origin within the uterine cervix.

METHODS

Following the identification of prominent signet ring cells in the stroma in a large loop excision of transformation zone (LLETZ) biopsy of cervix (the index case), a series of LLETZ specimens was prospectively examined for this phenomenon.

RESULTS

Focal collections of identical signet ring cells in 15% of the specimens were found. The cells were characterised by bland eccentric round or crescentic nuclei with a single cytoplasmic vacuole. The signet ring cells in the index case were vimentin positive, and negative with cytokeratins, epithelial membrane antigen and CD68, in keeping with a stromal derivation.

CONCLUSIONS

In all cases, the signet ring cells were in areas of thermal damage and they are believed to be an artefact of cauterisation; identical features have been described in transurethral resection of prostate specimens and also attributed to thermal damage. When the change is extensive in the cervix, there is potential for misdiagnosis as a signet ring carcinoma. Other cervical lesions with signet ring cells are discussed.