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Case Reports
. 2018 May 9:5:e36.
doi: 10.14309/crj.2018.36. eCollection 2018.

Metastatic Gastric Signet Ring Cell Carcinoma Mimicking Crohn's Disease

Michael W Winter  1 , Amr Dokmak  2 , Zachary Marnoy  1 , Shweta Sinagare  1 , Alexander N Levy  1
Affiliations
Case Reports

Metastatic Gastric Signet Ring Cell Carcinoma Mimicking Crohn's Disease

Michael W Winter et al. ACG Case Rep J. .

Abstract

Signet-ring cell carcinoma (SRCC) is an adenocarcinoma characterized by mucin-producing cells and most commonly arises in the stomach. Colonic SRCC can share features of colitis, including long segments of concentric bowel wall thickening and ulcerated mucosa with regions of sparing. We describe a rare case of metastatic gastric SRCC mimicking Crohn's disease. Our patient underwent 2 colonoscopies, and biopsies revealed chronic active inflammation with no evidence of malignancy. The diagnosis of SRCC was only made after colectomy was performed for recurrent bowel obstruction.

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Figures

Figure 1
Figure 1
Magnetic resonance enterography demonstrating thickened transverse colon and proximal dilation of the right colon.
Figure 2
Figure 2
(A) Poorly differentiated carcinoma with signet-ring cell features involving the colonic wall, serosal surface, and subserosal adipose tissue, with no evidence of in situ carcinoma. (B) Mucicarmine immunohistochemical stain highlighting infiltrating tumor cells in the colon. (C) Periodic acid–Schiff stain of antral type gastric mucosa highlighting tumor cells of poorly differentiated adenocarcinoma, signet-ring cell type.
Figure 3
Figure 3
Gastric mucosa with linitus plastica appearance on upper endoscopy.
See this image and copyright information in PMC

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