Pathology of the Gastrointestinal Tract

2017 Edition
| Editors: Fátima Carneiro, Paula Chaves, Arzu Ensari

Signet Ring Cell Carcinoma

  • Chella R. S. van der PostEmail author
  • Fátima Carneiro
Reference work entry


Diffuse carcinoma; Poorly cohesive carcinoma


Signet ring cell carcinoma is defined as a tumor composed predominantly (more than 50%) or exclusively of signet ring cells, characterized histologically by cells with a large vacuolated mucinous cytoplasm and an eccentrically placed flattened nucleus.

Various classification schemes for gastric cancer have been proposed; the Laurén and the World Health Organization (WHO) classification systems are the most widely used. Gastric adenocarcinomas are subtyped in the WHO classification based on the predominant morphologic component of the tumor. These subtypes include tubular, papillary, mucinous, poorly cohesive (including signet-ring cell type), and mixed carcinomas. The Laurén scheme separates gastric adenocarcinomas into intestinal, diffuse, and mixed or indeterminate subtypes. Signet ring cell carcinomas are categorized into the diffuse type in the Laurén scheme.

Clinical Features

  • Incidence

    Gastric adenocarcinoma is the...

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References and Further Reading

  1. Allum, W. H., Blazeby, J. M., Griffin, S. M., Cunningham, D., Jankowski, J. A., & Wong, R. (2011). Guidelines for the management of oesophageal and gastric cancer. Gut, 60(11), 1449–1472.CrossRefGoogle Scholar
  2. Bosman, F. T., Carneiro, F., Hruban, R. H., & Theise, N. D. (2010). WHO classification of tumours of the digestive system (4th ed.). Lyon: IARC.Google Scholar
  3. Heger, U., Blank, S., Wiecha, C., Langer, R., Weichert, W., Lordick, F., Bruckner, T., Dobritz, M., Burian, M., Springfeld, C., Grenacher, L., Siewert, J. R., Büchler, M., & Ott, K. (2014). Is preoperative chemotherapy followed by surgery the appropriate treatment for signet ring cell containing adenocarcinomas of the esophagogastric junction and stomach?Google Scholar
  4. Jiang, C. G., Wang, Z. N., Sun, Z., Liu, F. N., Yu, M., & Xu, H. M. (2011). Clinicopathologic characteristics and prognosis of signet ring cell carcinoma of the stomach: Results from a Chinese mono-institutional study. Journal of Surgical Oncology, 103(7), 700–703.CrossRefGoogle Scholar
  5. Koyama, T., Sekine, S., Taniguchi, H., Tsuda, H., Ikegami, M., Hano, H., & Kushima, R. (2011). Hepatocyte nuclear factor 4A expression discriminates gastric involvement by metastatic breast carcinomas from primary gastric adenocarcinomas. Human Pathology, 42(11), 1777–1784.CrossRefGoogle Scholar
  6. Lauren, P. (1965). The two histological main types of gastric carcinoma: Diffuse and so-calles intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathologica et Microbiologica Scandinavica, 64, 31–49.CrossRefGoogle Scholar
  7. Messager, M., Lefevre, J. H., Pichot-Delahaye, V., Souadka, A., Piessen, G., & Mariette, C. (2011). The impact of perioperative chemotherapy on survival in patients with gastric signet ring cell adenocarcinoma: a multicenter comparative study. Ann Surg, 254, 684–693.Google Scholar
  8. Mimata, A., Fukamachi, H., Eishi, Y., & Yuasa, Y. (2011). Loss of E-cadherin in mouse gastric epithelial cells induces signet ring-like cells, a possible precursor lesion of diffuse gastric cancer. Cancer Science, 102(5), 942–950.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Chella R. S. van der Post
    • 1
    Email author
  • Fátima Carneiro
    • 2
  1. 1.Department of PathologyRadboud University Medical CenterNijmegenThe Netherlands
  2. 2.Faculty of Medicine of Porto UniversityCentro Hospitalar São João and Ipatimup/i3SPortoPortugal