Differentiation of CT Findings Between Signet Ring Cell and Non-signet Ring Cell Carcinomas of the Radiology

Abstract

Purposes: To describe and differentiate the clinical features and CT findings between signet ring cell (SRC) and non-signet ring cell (NSRC) gastric carcinoma. Materials and Methods: A retrospective study of clinical features and MDCT findings of 95 patients (54 men, 41 women; mean age 59.2 years; range 18-89 years) proven primary gastric adenocarcinoma from January 2010 to August 2013 were reviewed. There were 43 patients (45.3%) proven SRC carcinoma and 52 patients (54.7%) with NSRC carcinoma. The CT features were analyzed for gross morphology, tumor location, degree and pattern of enhancement, direct extension and metastases. Results: Statistically significant differences between the patients with SRC and NSRC carcinomas were noted in the mean patient age (53.5 years vs. 65.4 years; P < 0.01), mean tumor thickness (1.8 cm vs. 2.2 cm; P = 0.03), pattern and degree of tumor enhancement. SRC carcinoma was more common appeared layered enhancement and hyper-enhancement, whereas NSRC carcinoma was more frequent found heterogeneous and iso-enhancement (P = 0.02 and P <0.01). There were no statistically significant differences in patient gender, tumor location, gross appearance, lymph node metastasis, distant metastasis and peritoneal seeding between patients with SRC and NSRC carcinomas of the stomach. Conclusion: MDCT could help to distinguish gastric carcinoma with SRC from NSRC type, primarily by smaller tumor thickness, presence of layered and hyper- enhancement appearances. Keywords: Signet ring cell carcinoma, Adenocarcinoma, Stomach, CT findings