Two Cases of Invasive Carcinoma of the Breast Composed Mostly of Signet Ring Cells in the Fine Needle Aspiration Cytology

Lee, Won Mi; Kim, Wan Sup; Kim, Eun Kyung; Joo, Jong Eun

Abstract

Scattered single cells or variable sized clusters of signet ring cells in the aspirated smears of breast lesions are almost exclusively associated with carcinoma. The signet ring cells are defined as those containing a prominent intracytoplasmic vacuole or amorphous cytoplasm diffusely dispersed with mucin. The primary signet ring cell carcinoma of the breast behaves more aggressively than carcinoma without signet ring cells. Therefore, it is very important to make a correct diagnosis of signet ring cell carcinoma. Fine needle aspiration cytology is useful for diagnosis of breast lesions including signet ring cell carcinoma. We report two cases, which showed mostly signet ring cells in the aspirated smears of the breast. One case consisted of numerous individual signet ring cells and variable sized cell clusters in rather mucoid background. The tumor cells had abundant amorphous cytoplasm filled with dispersed mucin or occasionally mucin vacuoles(PAS +) and eccentric nuclei. The resected mass revealed mucinous carcinoma. The other showed the cytologic findings of low cellularity, and small loosely cohesive signet ring cell clusters with mild nuclear pleomorphism. It was confirmed as lobular signet ring cell carcinoma in the resected tumor.