Pseudo-Signet Ring Cells: Diagnostic Pitfalls—Insights from Case Reports

Background: The term “pseudo-signet ring cell” in the gastrointestinal and biliary tract refers to benign cells with signet ring-like morphology that resemble the malignant counterpart seen in poorly differentiated adenocarcinomas. Clinical Significance: Given this close resemblance to malignant cells, they can pose a diagnostic challenge for pathologists. Awareness of this diagnostic pitfall is crucial to avoid misdiagnoses and overtreatment of patients. Case Presentation: Herein, we provide an overview of an array of clinical presentations of pseudo-signet ring cells, particularly focusing on the three most frequent clinical scenarios, and briefly discuss the possible etiologies for this phenomenon. Conclusions: Pseudo-signet ring cells are a rare but important diagnostic pitfall that require careful morphological evaluation, contextual awareness, and clinicopathologic correlation to avoid misdiagnosis.