Papillary urothelial carcinoma of the urinary bladder demonstrating prominent signet-ring cells in a smear - A case report

BACKGROUND: The appearance of numerous signet ring cells (SRCs) without any other type of adenocarcinoma cells originating in papillary transitional cell carcinoma (TCC) in a urine smear is rare. CASE: The cytology from mucus-urine that was initially obtained by washing from a 69-year-old female revealed three different types of cells: (1) numerous single SRC carcinoma-type cells, (2) low grade TCC-type cells arranged in sheets, and (3) intermediate (transitional)-type cells with both aspects of TCC and adenocarcinoma (SRC carcinoma) and mucus in the background. The latter two cell populations were retrospective confirmed after histologic diagnosis of a primary papillary TCC with glandular differentiation. CONCLUSION: One should keep in mind that even a low grade papillary TCC with glandular differentiation of the bladder can exhibit excessive SRC-type cells in urine.