Signet ring lymphoma: a potential diagnostic mishap.

Signet ring lymphomas are proliferations of malignant lymphoid cells containing cytoplasmic inclusions or vacuoles that displace the nucleus to the side, imparting a "signet ring" appearance. These signet ring cells, particularly those with cytoplasmic vacuoles, may be mistaken for an adenocarcinoma rather than a lymphoma, if sufficient material is not available to differentiate the case by immunohistochemical stains or flow cytometry. The pathologist must also be aware of this entity so that appropriate studies may be untaken.