Micropapillary Variant of Transitional Cell Carcinoma of the Urinary Bladder Histologic Pattern Resembling Ovarian Papillary Serous Carcinoma

Amin, Mahul B.; Ro, Jae Y.; El-Sharkawy, T. Y.; Lee, Kwang M.; Troncoso, Patricia; Silva, Elvio G.; Ordóñez, Nelson G.; Ayala, Alberto G.

doi:10.1097/00000478-199412000-00005

Cited by 388 publications

(387 citation statements)

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“…4,24,25 Tumors that demonstrate an admixture of conventional urothelial carcinoma and micropapillary carcinoma often demonstrate metastases composed of the micropapillary carcinoma component, supporting the aggressive nature of this variant. 4,24,25 Even in primary tumors, the percentage of micropapillary carcinoma present is significantly related to the stage of disease and mortality: 25 a relative mortality risk of 2.4 is present when the component of micropapillary carcinoma is 450% as compared with those with pure conventional urothelial carcinoma or o50% micropapillary carcinoma. 26 One of the first reports of micropapillary carcinoma found that 94% of patients had muscle-invasive disease at the time of presentation, with frequent angiolymphatic invasion.…”

Section: Discussionmentioning

confidence: 93%

“…The index increased to 1.85 for metastatic micropapillary carcinoma. 4,24 In another study, expressions of known predictors of poor prognosisincluding p53, MIB-1, Aurora-A, and survivin-are increased in micropapillary carcinoma as compared with conventional urothelial carcinoma. 28 In particular, Aurora-A is a known activator of genetic pathways involving centrosome amplification and chromosomal missegregation, resulting in increased chromosome copy number and nuclear DNA content.…”

Section: Discussionmentioning

confidence: 97%

“…26 One of the first reports of micropapillary carcinoma found that 94% of patients had muscle-invasive disease at the time of presentation, with frequent angiolymphatic invasion. 4 A more recent review found that 91% of patients had at least clinical T1 disease at presentation. 1 The exact mechanism by which micropapillary carcinoma pathology differs from that of conventional urothelial carcinoma is unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Histologically, micropapillary carcinoma resembles papillary serous carcinoma of the ovary with filiform projections that lack a central vascular core and are present within prominent retraction spaces. 1 Although micropapillary carcinoma represents only 0.7-2.2% of bladder cancers, [1][2][3] patients with this form of carcinoma often present at an advanced stage with muscle-invasive or metastatic disease 2,4 and a significantly reduced survival as compared with conventional urothelial carcinoma. Even when patients present with non-muscle-invasive disease, subsequent pathological upstaging occurs in up to 75% of patients and occult lymph-node disease may be present in 38% of patients.…”

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confidence: 99%

“…The goal of this study was to evaluate HER2 protein expression and HER2 gene amplification in this unique subset of urothelial carcinoma patients to determine whether HER2-targeted systemic therapy would provide a novel treatment option in this population, especially given the aggressiveness of this disease and the potential for metastatic disease by the time of presentation. 2,4 Materials and methods…”

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HER2 gene amplification occurs frequently in the micropapillary variant of urothelial carcinoma: analysis by dual-color in situ hybridization

et al. 2011

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Human epidermal growth factor receptor-2 (HER2) is a well-recognized growth-promoting factor in cancer, although its application to urothelial carcinoma has been limited because of a low frequency of gene amplification. We evaluated HER2 protein expression and gene amplification in micropapillary carcinoma, a rare but highly aggressive variant of urothelial carcinoma by dual-color in situ hybridization. Gene amplification was defined by a HER2:CHR17 ratio of Z2.2; low and high levels of amplification were further defined as o2.5 and Z2.5, respectively. Immunohistochemistry was used to determine HER2 protein expression using the American Society of Clinical Oncology/College of American Pathologists Guidelines of HER2 staining. Protein expression, gene amplification, and chromosome 17 aneusomy were compared by Jonchkeere-Terpstra and Cochran-Armitage trend tests. In all, 19 of the 20 micropapillary carcinoma samples yielded usable dual-color in situ hybridization and immunohistochemistry results for evaluation. Overall, 68% (n ¼ 13) demonstrated HER2 protein expression of 2 þ to 3 þ staining. Gene amplification was present in 42% of samples (n ¼ 8), with 100% correlation with 2 þ and 3 þ protein expression. Gene amplification and protein expression were significantly associated (P ¼ 0.01). Overall, 53% of samples (n ¼ 10) had aneusomy of chromosome 17. Chromosome 17 aneusomy was present in approximately half of the samples evaluated, suggesting inherent genomic instability in this variant of urothelial carcinoma. However, increased HER2:CHR17 ratios demonstrate increased HER2 expression due to amplification in the majority of micropapillary carcinomas. These results suggest that HER2-targeted therapy may be successful on the genomic level in patients with this disease.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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HER2 gene amplification occurs frequently in the micropapillary variant of urothelial carcinoma: analysis by dual-color in situ hybridization

et al. 2011

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Pathology of transitional cell carcinoma of the bladder and its clinical implications

Lapham

Staerkel

et al. 1997

Semin. Surg. Oncol.

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Transitional cell carcinomas are divided into superficial and muscle‐invasive tumors. Most of them are superficial tumors, and approximately 15‐20% are muscle‐invasive carcinomas. Pathologists play a significant role in diagnosing bladder tumors and in reporting features important for determining prognosis. We will review the cytologic and histopathologic features that help determine prognosis, including depth of invasion, tumor grade, multicentricity, tumor size, and the presence of vascular/lymphatic invasion, blood group antigen expression, proliferative indices, and molecular markers. Brief mention will be made of specimen handling, interpretation, reporting, and histologic variants of transitional cell carcinoma. Semin. Surg. Oncol. 13:307‐318, 1997. © 1997 Wiley‐Liss, Inc.

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Uncommon Cancers of the Bladder

Siefker-Radtke

Czerniak

Dinney

et al. 2006

Textbook of Uncommon Cancer

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Micropapillary Variant of Transitional Cell Carcinoma of the Urinary Bladder Histologic Pattern Resembling Ovarian Papillary Serous Carcinoma

Cited by 388 publications

References 0 publications

HER2 gene amplification occurs frequently in the micropapillary variant of urothelial carcinoma: analysis by dual-color in situ hybridization

HER2 gene amplification occurs frequently in the micropapillary variant of urothelial carcinoma: analysis by dual-color in situ hybridization

Pathology of transitional cell carcinoma of the bladder and its clinical implications

Uncommon Cancers of the Bladder

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