Fine‐needle aspiration diagnosis of lymphomas with signet ring cell features

Abstract

BACKGROUND: Lymphoma with signet ring cell features (LSF) is a rare morphologic variant of non-Hodgkin lymphoma.Although it has been well documented in the surgical pathology literature, to the best of the authors's knowledge, the

A rare case of signet ring cell lymphoma: Diagnosis aided by immunofluorescent staining

“…The authors of the case series emphasized distinguishing features of SRCL from melanoma, adenocarcinoma, liposarcoma as well as benign histiocytic proliferations. [10]…”

Histologic transformation to diffuse large B cell lymphoma with profuse signet‐ring cell change in bone marrow and lymph node biopsies in a patient with marginal zone lymphoma. A cytologic‐histologic correlation

“…Dear Sir, Lymphomas with signet-ring cell change are an uncommon morphologic variant of non-Hodgkin lymphoma (NHL) in which the whole tumor contains variable proportions of lymphocytes with a signet-ring appearance. [1][2][3][4] Most reported cases are follicular lymphomas with a morphologic description of the lymph node or bone marrow findings. [1][2][3][4][5][6][7][8][9] To the best of our knowledge, signet-ring cell change in MALT lymphomas are not frequently reported and the histologic transformation to diffuse large B cell lymphoma (DLBCL) with profuse signet-ring cell change in bone marrow and lymph node biopsies in a patient with marginal zone lymphoma has not yet been described.…”

“…The differential diagnosis of signet-ring cell lymphomas is wide, and includes metastatic gastric, prostatic, lung, breast, and other gastrointestinal carcinomas, melanomas and liposarcomas. [1][2][3]6,8,9 In signet-ring cell lymphomas the nuclear details of the signet-ring cells are usually quite similar to those of adjacent nonvacuolated lymphoid cells, in addition conventional histochemical (PAS and Mucin staining) as well as IHC/molecular studies are useful ancillary tools to distinguish between these tumors. [1][2][3][4][5][6][7][8][9] In this case, the previous history of MALT lymphoma, the presence of a high-grade lymphoma component with large, atypical lymphoid cells, the positivity for B-cell markers and lack of PAS or mucin staining makes the lymphomatous nature easier to recognize, supporting the diagnosis of signet-ring cell lymphoma over their mimics.…”

“…The vacuoles in the signet-ring cells can represent an accumulation of monoclonal immunoglobulin or membranous invagination; however, others have described cytoplasm as clear or empty that could be merely artifactual. 1,9 The presence of signet-ring cells does not appear to affect the prognosis of the primary subtype of lymphoma and is not associated with aggressive evolution as signet-ring cell carcinoma. 1,9 However, in the recent study published by Zhang et al half the cases with signet-ring cell morphology contained DLBCL components either together with follicular lymphoma or other low grade NHL, suggesting that signet-ring cell lymphoma might have a high probability of DLBCL transformation.…”

“…1,9 The presence of signet-ring cells does not appear to affect the prognosis of the primary subtype of lymphoma and is not associated with aggressive evolution as signet-ring cell carcinoma. 1,9 However, in the recent study published by Zhang et al half the cases with signet-ring cell morphology contained DLBCL components either together with follicular lymphoma or other low grade NHL, suggesting that signet-ring cell lymphoma might have a high probability of DLBCL transformation. 9 In this case, we highlight the connotation of recognizing this unusual morphologic variant of lymphoma to avoid a misinterpretation in the final diagnosis, especially in small biopsies (Tru-Cut from lymph node or cytologic samples).…”