PDF(Pubmed)
Abstract：
The signet-ring cell variant of squamous cell carcinoma (SCC) is an extremely rare histological subtype, with only 24 cases (including the present case) reported in the Medline database: 15 affecting the external surface of the body, 3 in the lung, 2 affecting the uterine cervix, 1 involving the gingiva, another one affecting the esophagus and the present case that is the first reported at the gastro-esophageal junction (GEJ). In one case, the location of the lesion was not mentioned. A 59-year-old male patient underwent segmental eso-gastrectomy for carcinoma of the GEJ. The microscopic examination showed a pT3N1-staged SCC composed of solid nests admixed in over 30% of the tumor, with cells having eccentrically located nuclei and clear vacuolated cytoplasm. The signet-ring cells did not show mucinous secretion and were positive for keratin 5/6 and vimentin, with nuclear expression of β-catenin and Sox2 and focal membrane positivity for E-cadherin. Based on these features, the case was considered a signet-ring SCC with epithelial-mesenchymal transition. Thirty-one months after surgery, the patient was disease-free, with no local recurrence and no known distant metastases. In SCC, a signet-ring cell component might be an indicator of the dedifferentiation of tumor cells towards a mesenchymal molecular subtype.
摘要：
鳞状细胞癌（SCC）的印戒细胞变体是一种极为罕见的组织学亚型，Medline数据库中只报告了24例（包括目前的病例）：15例影响身体外表面，3在肺部，2影响子宫颈，1涉及牙龈，另一例影响食道，目前是胃食管交界处（GEJ）首次报道。在一个案例中,未提及病变的位置.一名59岁的男性患者因GEJ癌接受了节段性胃底切除术。显微镜检查显示pT3N1阶段的SCC由超过30％的肿瘤中混合的实体巢组成，细胞具有偏心定位的细胞核和清晰的液泡质。印戒细胞不显示粘液性分泌，角蛋白5/6和波形蛋白阳性，β-catenin和Sox2的核表达和E-cadherin的局灶膜阳性。基于这些特征,该病例被认为是具有上皮-间质转化的印戒SCC.手术后31个月,病人没有疾病，没有局部复发，也没有已知的远处转移。在SCC中,印戒细胞成分可能是肿瘤细胞向间质分子亚型去分化的指标。
