Signet Ring Cell of the Non-Neoplastic Endometrium: A Case Report and Literature Review

Abstract

The observation of signet ring cells in endometrial biopsy results raises the possibility of the existence of a malignant primary or metastatic adenocarcinoma. We describe the case of a middle aged woman whose endometrial biopsy and curettage specimens contained signet ring cells indicating stromal decidual changes. Positive cytokeratin and CD10 immunohistochemistry staining results were revealed in the signet ring cells, features favoring a diagnosis of endometrial stromal cells showing decidual changes rather than a primary or metastatic endometrial neoplasm. Upon immunohistochemistry evaluation, they presented as vacuolated, decidualized endometrial stromal cells. Awareness of this morphologic change in the endometrial stroma can prevent overdiagnosis and overtreatment as primary or metastatic signet ring cell adenocarcinoma. Recognized by this morphologic feature, signet ring cells, or their close mimics, should not always be considered as a high grade or poorly differentiated adenocarcinoma.




doi: http://dx.doi.org/10.4021/jcgo42e