{"doi":"10.1159/000335118","title":"Signet Ring Cell Carcinoma in Urine Cytology: Cytomorphologic Findings and Differential Diagnosis","abstract":"<jats:p>&lt;i&gt;Background:&lt;/i&gt; Signet ring carcinoma is an exceedingly rare and aggressive variant of primary bladder carcinoma. The cytomorphologic features of this rare entity in urinary specimens have not been well characterized. &lt;i&gt;Methods:&lt;/i&gt; Twenty-seven cases of signet ring cell carcinoma of the urinary bladder were identified from the pathology archives of The Johns Hopkins Hospital (1989–2011). Of these, 6 cases with prior urinary cytology specimens were studied. &lt;i&gt;Results:&lt;/i&gt; There were 5 males and 1 female, with a mean age of 62 years. The presenting complaints included hematuria with or without symptoms of bladder irritation. Histopathologically, there were 5 cases of primary bladder carcinoma and 1 case of metastatic colonic signet ring cell carcinoma. The salient cytomorphologic features included scattered malignant epithelial cells, displaying distinct cell borders, abundant cytoplasm with a single large, discrete mucin vacuole, and eccentric irregular nuclei with prominent nucleoli. Primary adenocarcinoma additionally revealed a few intact malignant glandular epithelial fragments. Metastatic colonic signet ring cell carcinoma displayed predominantly singly dispersed malignant cells with eccentrically placed, oval nuclei with occasional small nucleoli and a moderate amount of vacuolated cytoplasm. &lt;i&gt;Conclusion:&lt;/i&gt; Signet ring cell carcinomas are rarely encountered in urinary cytology. The differential diagnosis includes distended histiocytes or degenerated urothelial cells, primary signet ring cell carcinoma, and metastatic adenocarcinoma.</jats:p>","journal":"Acta Cytologica","year":2012,"id":680433,"datarank":0.38474240361923057,"base_score":2.5649493574615367,"endowment":2.5649493574615367,"self_citation_contribution":0.38474240361923057,"citation_network_contribution":0.0,"self_endowment_contribution":0.38474240361923057,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1777766,"name":"Armanda D. Tatsas","orcid":null,"position":1,"is_corresponding":false},{"id":545383,"name":"Syed Z. Ali","orcid":"0000-0002-9069-8427","position":2,"is_corresponding":false},{"id":1328595,"name":"Hui Guan","orcid":"0000-0001-9128-2231","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Signet Ring Cell Carcinoma in Urine Cytology: Cytomorphologic Findings and Differential Diagnosis","abstract":"<jats:p>&lt;i&gt;Background:&lt;/i&gt; Signet ring carcinoma is an exceedingly rare and aggressive variant of primary bladder carcinoma. The cytomorphologic features of this rare entity in urinary specimens have not been well characterized. &lt;i&gt;Methods:&lt;/i&gt; Twenty-seven cases of signet ring cell carcinoma of the urinary bladder were identified from the pathology archives of The Johns Hopkins Hospital (1989–2011). Of these, 6 cases with prior urinary cytology specimens were studied. &lt;i&gt;Results:&lt;/i&gt; There were 5 males and 1 female, with a mean age of 62 years. The presenting complaints included hematuria with or without symptoms of bladder irritation. Histopathologically, there were 5 cases of primary bladder carcinoma and 1 case of metastatic colonic signet ring cell carcinoma. The salient cytomorphologic features included scattered malignant epithelial cells, displaying distinct cell borders, abundant cytoplasm with a single large, discrete mucin vacuole, and eccentric irregular nuclei with prominent nucleoli. Primary adenocarcinoma additionally revealed a few intact malignant glandular epithelial fragments. Metastatic colonic signet ring cell carcinoma displayed predominantly singly dispersed malignant cells with eccentrically placed, oval nuclei with occasional small nucleoli and a moderate amount of vacuolated cytoplasm. &lt;i&gt;Conclusion:&lt;/i&gt; Signet ring cell carcinomas are rarely encountered in urinary cytology. The differential diagnosis includes distended histiocytes or degenerated urothelial cells, primary signet ring cell carcinoma, and metastatic adenocarcinoma.</jats:p>","is_dataset_classified":null,"base_score":2.5649493574615367,"endowment":2.5649493574615367,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"22378081","pmcid":null,"openalex_id":"https://openalex.org/W1987839814","authors":[],"funders":[],"total_grants":0,"fwci":1.164,"citation_percentile":0.7900891,"influential_citations":0,"citation_trend":[{"year":2013,"count":1},{"year":2014,"count":1},{"year":2015,"count":2},{"year":2018,"count":1},{"year":2020,"count":2},{"year":2021,"count":1},{"year":2022,"count":1},{"year":2023,"count":1},{"year":2024,"count":2}],"oa_status":"closed","license":"https://www.karger.com/Services/SiteLicenses","oa_locations":[{"url":"https://www.karger.com/Article/Pdf/335118","host_type":"publisher"},{"url":"https://doi.org/10.1159/000335118","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/22378081","host_type":"repository"}],"fields_of_study":["Urinary and Genital Oncology Studies","Bladder and Urothelial Cancer Treatments","Cancer Diagnosis and Treatment","Adenocarcinoma","Aged","Carcinoma, Signet Ring Cell","Cell Nucleus","Colonic Neoplasms","Cytoplasm","Female","Histiocytes","Humans","Male","Middle Aged","Retrospective Studies","Urinary Bladder","Urinary Bladder Neoplasms","Urothelium"],"mesh_terms":["Adenocarcinoma","Aged","Urinary Bladder","Urinary Bladder Neoplasms","Cell Nucleus","Colonic Neoplasms","Cytoplasm","Female","Histiocytes","Humans","Male","Middle Aged","Retrospective Studies","Carcinoma, Signet Ring Cell","Urothelium"],"keywords":["Medicine","Signet ring cell","Pathology","Differential diagnosis","Urine cytology","Cytology","Cytopathology","Signet ring cell carcinoma","Carcinoma","Cystoscopy","Adenocarcinoma","Cancer","Internal medicine"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-17T15:07:57.780421Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}