Signet-ring cell lymphoma. Ultrastructural and immunohistochemical features of three varieties

Abstract

An ultrastructural and immunohistochemical study was performed on three malignant lymphomas of follicular center cell origin with signet‐ring cells. The first case corresponded to a diffuse lymphoma with follicular center cells and plasmacytic features; the other two cases corresponded to the nodular centrocytic‐centroblastic category. The neoplastic lymphocytes contained Russell bodylike inclusions, clear vacuoles, and ill‐defined eosinophilic masses, respectively, which produced a displacement of the nuclei to the periphery. Ultrastructurally, there were three different morphologic types because of the following cytoplasmic changes: the accumulation of electron‐dense granular material in the cisternae of the rough endoplasmic reticulum; the formation of clear vacuoles with a smooth limiting membrane; and, the presence of granular‐fibrillar and crystalline material in the hyaloplasm without a limiting membrane. The first type of signet‐ring cell contained monoclonal immunoglobulin (IgM‐K). No immunoglobulins were found in the clear cytoplasmic vacuoles of the second type; however, the rim of cytoplasm stained for IgG, kappa and lambda. Finally, the third type showed IgG and kappa light chain in the hyaloplasmic inclusions. It is concluded that the signet‐ring cell appearance is due to an abnormal production and secretion of immunoglobulins.

Signet Ring Epithelioid Stromal Tumor of the Small Intestine

“…Signet ring-like cells have also been found in epithelial neoplasms, including malignant melanoma [ 3,4] , meningioma [ 6] , ependymoma [ 7] , malignant lymphoma [ 5] , and have been observed in peculiar non-neoplastic histiocytic reactions [ 1,2] . In smooth muscle tumors with signet ring cells, the differential diagnosis can be further complicated by expression of lowmolecular-weight cytokeratin [ 11] , a finding that has also been documented in rhabdomyosarcomas, meningiomas, gliomas, melanomas, and anaplastic lymphomas [ 12± 18] .…”

“…A signet ring-like appearance has also been documented in a variety of conditions including polyvinylpyrrolidone storage disease [ 1] ; sinus histiocytosis [ 2] ; nonepithelial neoplasms such as epithelioid hemangioendothelioma, melanocytic nevi, and malignant melanoma [ 3,4] ; several varieties of malignant lymphoma [ 5] ; meningioma [ 6] ; ependymoma [ 7] ; desmoplastic small round cell tumor [ 8] ; ovarian stromal tumors [ 9] ; and gastrointestinal stromal tumors [ 10] , particularly those with smooth muscle differentiation. Epithelioid mesenchymal neoplasms with signet ring cells are a potential diagnostic pitfall by light microscopy.…”

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

“…The signet ring cells in lymphoma are negative for cytokeratin and mucicarmine but are positive for leukocyte common antigen and B-cell or T-cell lymphoma-specific markers. 3,11,16 To distinguish LSF from metastatic melanoma with signet ring cell features in a lymph node, it is important to recognize that the nuclear features of melanoma cells are different from those of the surrounding lymphoid cells. Nonvacuolated melanoma cells typically demonstrate features such as binucleated cells, intranuclear pseudoinclusions, and prominent nucleoli.…”

“…Since its initial report in 1978 by Kim et al, 1 a number of such cases have been described in the surgical pathology literature. The vast majority of these cases were non-Hodgkin lymphoma of follicular center cell origin, [1][2][3][4][5][6][7] although other types of non-Hodgkin B-cell lymphomas, and even T-cell lymphoma and CD30-positive anaplastic large-cell lymphoma, have also been documented. [8][9][10][11] However, to the best of our knowledge, the cytologic features of LSF have been only sparsely reported.…”

Splenic B-cell marginal zone lymphoma with marked plasmocytic differentiation: tumor variant from Mott cells?

“…[12]впервыеописалэтиклетки, которыевдальнейшемназваливегочесть.Впоследу-ющих исследованиях выявили, что эти плазматиче-скиеклеткисодержатвосновномIgклассаМ(IgM) [13][14][15].КлеткиМоттамогутиметьразличнуюмор-фологическую картину в зависимости от размеров иколичествателецРассела [16].Онибываютперстне-видные(из-занахожденияядранаперифериивсвязи сперемещениемвнутриклеточнымIg) [17]иморуло-видные [18].…”