Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA.
Am J Surg Pathol. 2011 May;35(5):762-6. doi: 10.1097/PAS.0b013e318213f833.
Signet ring cell change is a benign process that can be mistaken for signet ring cell adenocarcinoma. Signet ring cell change remains confined within the basement membrane and lacks an infiltrative growth pattern. It typically lacks cellular atypia, nuclear hyperchromasia, prominent nucleoli, or mitotic activity. This study illustrates a case of signet ring cell change with mitotic activity in a background of Helicobacter pylori gastritis with a penetrating ulcer. The signet ring cell change shows normal E-cadherin expression, absence of p53 expression, and confinement within glands on reticulin staining. The intact gastric mucosa adjacent to the signet ring cells shows significant mitotic activity, which likely explains the mitoses within the signet ring cell change. Mitotic activity in signet ring cells should be interpreted in the context of adjacent mucosa and should not preclude the diagnosis of benign signet ring cell change. Reticulin staining of the involved glands is helpful for excluding the invasion of the lamina propria in signet ring cell change.
印戒细胞改变是一种良性过程，可能被误诊为印戒细胞腺癌。印戒细胞改变仍局限于基底膜内，缺乏浸润性生长模式。它通常缺乏细胞异型性、核深染、明显的核仁或有丝分裂活性。本研究描述了一例幽门螺杆菌胃炎伴穿透性溃疡背景下具有有丝分裂活性的印戒细胞改变。印戒细胞改变显示正常的 E-钙黏蛋白表达，无 p53 表达，并在网状纤维染色的腺体中受限。与印戒细胞相邻的完整胃黏膜显示出明显的有丝分裂活性，这可能解释了印戒细胞改变内的有丝分裂。印戒细胞中的有丝分裂活性应结合邻近黏膜进行解释，不应排除良性印戒细胞改变的诊断。受累腺体的网状纤维染色有助于排除印戒细胞改变中固有层的浸润。
