Histologic variants of urothelial carcinoma: differential diagnosis and clinical implications

López-Beltrán, Antonio; Liu, Cheng

doi:10.1016/j.humpath.2006.05.009

Cited by 203 publications

(198 citation statements)

References 95 publications

(104 reference statements)

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“…[11][12][13][14] These urothelial carcinomas having unequivocal glandular differentiation have been designated as having a 'mixed' or 'glandular' differentiation. This designation is not used for typical urothelial carcinomas containing pseudoglandular structures or occasional mucin-containing cell, as cytoplasmic mucin-containing cells are present in B14% of urothelial carcinomas.…”

Section: Discussionmentioning

confidence: 99%

Urothelial carcinoma with villoglandular differentiation: a study of 14 cases

et al. 2009

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Tumors of the urinary bladder may have a variety of histological patterns. Tumors with either glandular or villous features, such as villous adenomas, in situ adenocarcinomas, invasive adenocarcinomas, and variants of urothelial carcinoma such as micropapillary carcinomas have been described. However, urothelial carcinomas with both villous and glandular features have not been well characterized. We identified 14 cases of urothelial carcinoma with villoglandular differentiation. These cases were defined as having villoglandular features if they contained superficial finger-like processes lined by epithelium having true glandular lumina. Mean patient age at presentation was 70 years (range: 46-84 years) with a male predominance (5:1). A total of 3 cases (21%) were non-invasive, five cases (36%) had lamina propria invasion, five cases (36%) had muscularis propria invasion and one case (7%) had extravesicular extension. A concurrent high-grade papillary urothelial carcinoma component was identified in 11 cases (79%), micropapillary component in 5 (36%) cases, in-situ urothelial carcinoma component in 3 cases (21%), plasmacytoid component in 3 cases (21%), invasive adenocarcinoma in 2 cases, sarcomatoid carcinoma component in one case (14%), and small-cell carcinoma component in 1 case (7%). Cystitis cystica et glandularis was present in 3 cases (21%). Angiolymphatic invasion was identified in 3 cases (21%). Histologically, the villoglandular components were composed of finger-like processes lined by glands intimately admixed with high-grade urothelial carcinoma. Many of the glands had cribriform features lined by non-mucin producing cuboidal to columnar cells. Urothelial carcinoma with villoglandular differentiation are high-grade tumors typically seen in elderly males, characterized by superficial filliform processes lined by glands intimately admixed with high-grade urothelial carcinoma (in situ or invasive) and other aggressive variants of urothelial carcinoma. These relatively rare tumors should be recognized as a variant of urothelial carcinoma.

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Section: Discussionmentioning

confidence: 99%

Urothelial carcinoma with villoglandular differentiation: a study of 14 cases

et al. 2009

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“…123 Aggressive therapies may be considered for those patients with lymphovascular invasion, micropapillary variant, or nested variant of urothelial carcinoma.…”

Section: Pathology Reportingmentioning

confidence: 99%

“…148 Retraction artifact is prominent and almost uniformly present in the micropapillary variant of urothelial carcinoma (Figure 19a and b). 123 In suspicious cases, endothelial lined vessels can be highlighted by immunohistochemical staining for CD31 or CD34. The presence of vascular or lymphatic invasion, and whether immunohistochemical stains assisted in identifying this finding, should be included in the report.…”

Section: Lymphovascular Invasionmentioning

confidence: 99%

Staging and reporting of urothelial carcinoma of the urinary bladder

et al. 2009

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“…12,[15][16][17][18] Greater than 90% of bladder carcinomas are usualtype urothelial carcinoma; however, a small subset of tumors are recognized as variants of urothelial carcinoma because of their distinctive histological appearance and/or poor prognosis. 19,20 Two of these variant entities with poor prognosis are the plasmacytoid and micropapillary variants of urothelial carcinoma. The plasmacytoid variant is composed of discohesive oval-to-round cells with abundant eosinophilic cytoplasm and eccentrically located nuclei.…”

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confidence: 99%

E-cadherin expression in plasmacytoid, signet ring cell and micropapillary variants of urothelial carcinoma: comparison with usual-type high-grade urothelial carcinoma

et al. 2011

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Loss of E-cadherin expression has been linked to the invasive phenotypes of a variety of neoplasms, including lobular breast cancer. The expression of E-cadherin in variants of urothelial carcinoma relative to usual-type urothelial carcinoma, maximum depth of invasion and angiolymphatic invasion has not been well characterized. A total of eight cases of micropapillary urothelial carcinoma, four cases of plasmacytoid urothelial carcinoma, two cases of urothelial carcinoma with signet ring cell differentiation and two cases of urothelial carcinoma with mixed plasmacytoid and signet ring cell differentiation, all obtained from cystectomy/cystoprostatectomy cases, were identified. In all nine cases of usual-type invasive and noninvasive high-grade urothelial carcinoma were also included in the study. Immunohistochemical staining of E-cadherin was performed in all cases. Pathological parameters including depth of invasion and presence of angiolymphatic invasion were documented. Maximum depth of invasion: In micropapillary urothelial carcinoma, extravesical extension was seen in three of eight cases; muscularis propria invasion in four of eight cases; and lamina propria invasion in one of eight cases. In plasmacytoid urothelial carcinoma, extravesical extension was observed in two of four cases, and muscularis propria invasion and lamina propria invasion in one of four cases each. In urothelial carcinoma with signet ring cell differentiation, extravesical extension and muscularis propria invasion was seen in one of two cases each. In urothelial carcinoma with mixed plasmacytoid and signet ring cell differentiation, muscularis propria invasion and lamina propria invasion was observed in one of two cases each. In usual-type high-grade urothelial carcinoma, extravesical extension was seen in six of nine cases and noninvasive in three of nine cases. In angiolymphatic invasion, micropapillary urothelial carcinoma was observed in eight of eight cases; plasmacytoid urothelial carcinoma in two of four cases; urothelial carcinoma with signet ring cell differentiation in one of two cases; and urothelial carcinoma with mixed plasmacytoid and signet ring cell differentiation in one of two cases. Usual-type high-grade urothelial carcinoma was seen in six of nine cases. E-cadherin expression: All eight cases of micropapillary urothelial carcinoma were positive for E-cadherin in the micropapillary component and adjacent usual-type urothelial carcinoma. The four cases of plasmacytoid urothelial carcinoma, two cases of urothelial carcinoma with signet ring cell differentiation and two cases of urothelial carcinoma with mixed plasmacytoid and signet ring cell differentiation were all negative for E-cadherin. All nine additional cases of usual-type high-grade urothelial carcinoma were diffusely positive for E-cadherin. E-cadherin is diffusely positive in usual-type urothelial carcinoma and micropapillary urothelial carcinoma, irrespective of pathological stage and angiolymphatic invasion. Loss of E-cadherin expression may be a marker of...

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Histologic variants of urothelial carcinoma: differential diagnosis and clinical implications

Cited by 203 publications

References 95 publications

Urothelial carcinoma with villoglandular differentiation: a study of 14 cases

Urothelial carcinoma with villoglandular differentiation: a study of 14 cases

Staging and reporting of urothelial carcinoma of the urinary bladder

E-cadherin expression in plasmacytoid, signet ring cell and micropapillary variants of urothelial carcinoma: comparison with usual-type high-grade urothelial carcinoma

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