"Never miss signet-ring cell carcinoma in stomach, and never miss
giadia in small intestine". This is what I learnt from my
residency training. For every gastric biopsy, I will spend a
little more time looking for signet-ring cells; for every small
intestine biopsy I will start from the villous surface. Luckily, I
didn't miss this case, but I haven't seen any giadia yet.
This poor patient was also found to have ascites with metastatic
Signet-ring cell changes may be seen in reactive conditions of
stomach and intestines.