In fact, signet ring cell lesions (insitu and pagetoid) have not been described in patients without CDH1 PV or otherwise positive family history of DGC fulfilling clinical criteria for HDGC, therefore it is reasonable to conclude that early cancer in HDGC and sporadic setting might have difference histopathological features. Here, CDH1 is linked to CDH1-related diffuse gastric and lobular breast cancer syndrome.