Nested variant of urothelial carcinoma: a clinicopathologic and immunohistochemical study of 30 pure and mixed cases

Wasco, Matthew J.; Daignault, Stephanie; Bradley, Deborah; Shah, Rajal B.

doi:10.1016/j.humpath.2009.07.015

Cited by 100 publications

(91 citation statements)

References 26 publications

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“…Bu özelliğinden dolayı psödo-benign neoplazi olarak adlandırılmakta-dır. 32 Drew ve ark.nın mesanesinde ürotelyal karsinomun "nested" varyantı saptanan 16 hastalık serisinde tüm hastalara transüretral rezeksiyon uygulanmış ve ortalama 16,6 aylık izlem sonrası sadece 3 hastanın sağ olduğu bildirilmiştir. 33 Lin ve ark.nın 12 hastalık serisinde mesanesinde üretelyal karsinomun "nested" varyantı saptanan hastalara radikal sistektomi tedavisi uygulanmış ve ortalama 17,6 aylık izlem sonunda bir hasta dışındakilerin sağ olduğu ve 3 hastada metastaz geliştiği rapor edilmiştir.…”

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Rare Malign Tumors of Bladder: Review of the Literature

Yücel¹,

Keskın²

2017

J Reconstr Urol

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Ö ÖZ ZE ET T En sık primer mesane kanseri transizyonel hücreli (ürotelyal) karsinomlardır. Adenokarsinom ve skuamöz hücreli karsinom, transizyonel hücreli karsinomlardan daha az sıklıkla görül-mektedir. Bu üç tümörün dışında birkaç yaygın olmayan, fakat ürotelyal karsinomdan ayrımlarının yapılması açısından önemli olan malign mesane tümörü vardır. Bu mesane kanserlerinin hepsi nadir görülmektedir ve küçük hasta serilerinde veya tek hastalık olgu sunumlarında tanımlanmışlardır. Bu nadir tümörlerin farklı/spesifik tedavi yaklaşımlarının olması bunların tanınmasını önemli hâle getirmiştir. Bu tümörlerin neden olduğu en sık şikâyet "gross" hematüridir. Daha az sıklıkla hastalarda dizüri, obstrüktif işeme semptomları veya abdominal kitle görülebilmektedir. Mesanede gö-rülen nadir malign kitleler leiomiyosarkom, rabdomiyosarkom, anjiyosarkom, malign fibroz histiyositom, primitif nöroektodermal tümör, malign periferik sinir kılıfı tümörü, hemanjiyoperiostoma, küçük hücreli mesane kanseri, mikropapiller ürotelyal karsinom, ürotelyal karsinomun "nested" varyantı, sarkomatoid karsinom, alveolar "soft-parts" sarkom, liposarkom, kondrosarkomdur. Mesanenin nadir malign tümörlerinin değişik biyolojik, patolojik ve klinik özelliklerinin anlaşılması klinisyenlere bu tümörlerle karşılaşmaları durumunda hastaya uygun tedavi başlamaları açısından yol gösterici olacaktır. Bu tümörlerin nadiren görülmeleri ve geniş hasta sayılı çalışma-ların olmaması tedavi protokollerinin net olarak ortaya konulmasını engellemektedir. Bu nadir tü-mörlerin tedavi protokollerinin ve klinik seyirlerinin daha iyi anlaşılması hastaların hayat kalitesini artıracaktır. Bu çalışmada, mesaneden çıkan bu nadir malign tümörlerin yaygın klinik göstergeleri, morfolojik özellikleri ve tedavi yaklaşımları ortaya konulmuştur.A An na ah ht ta ar r K Ke el li im me el le er r: : Mesane; leiyomiyosarkom; karsinom, değişici hücreli A AB BS ST TR RA AC CT T Most primary bladder cancer are transitional cell (urothelial) carcinomas. Adenocarcinoma and squamous cell carcinoma are seen less frequently than transitional cell carcinomas. Apart from these three tumors, there are several uncommon but significant malign bladder tumors that must be differentiated from urothelial carcinomas. These bladder cancers are all rare and have been described in small series and isolated case reports. The importance of recognizing these rare tumors since some of them may require a different/specific therapeutic approach. Gross hematuria is the most common clinical sign of these tumors. Less frequently, patients complain dysuria, obstructive voiding symptoms or abdominal mass. These tumors are leiomyosarcoma, rhabdomyosarcoma, angiosarcoma, malignant fibrous histiocytoma, primitive neuroectodermal tumor, malignant peripheral nerve sheath tumor, hemangiopericytoma, small cell bladder carcinoma, micropapillary urothelial carcinoma, nested variant of urothelial carcinoma, sarcomatoid carcinoma, alveolar soft-parts sarcoma, liposarcoma, chondrosarcoma. Understanding the various biological, path...

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Rare Malign Tumors of Bladder: Review of the Literature

Yücel¹,

Keskın²

2017

J Reconstr Urol

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“…Consequently, it seems that 'inverted/endophytic' UC is the most appropriate terminology as it accurately depicts the morphology of such tumors. Secondly, it appears that cases described as the 'large nested' variant of UC represent a highly selected cohort of inverted/endophytic UCs originating from consultation material, in which the low- mainly due to the lack of large series with long term follow-up (11)(12)(13) closely mimicking non-invasive low-grade urothelial papillary urothelial carcinoma with inverted growth pattern. Von Brunn nests proliferation may also be included in the differential diagnosis (original magnification X100).…”

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confidence: 99%

Inverted urothelial carcinoma: a series of 12 cases with a wide morphologic spectrum overlapping with the large nested variant

et al. 2015

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“…3 Nested urothelial carcinoma is a specific variant of invasive urothelial carcinoma in which the invasive urothelial nests are deceptively cytologically bland and mimic von Brunn nests 5 ; despite their bland cytologic features, nested urothelial carcinomas can often be deeply invasive. 6,7 In general, nested urothelial carcinomas are composed of somewhat disordered, confluent, anastomosing urothelial nests (Figure 2, C). The base of nested urothelial carcinomas in well-oriented sections is generally irregular with an infiltrative edge compared to the generally linear, demarcated base seen in most cases of pseudocarcinomatous hyperplasia (Figure 2, D).…”

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confidence: 99%

“…Many nested urothelial carcinomas are deeply invasive, and presence of urothelial nests within the muscularis propria would essentially exclude the diagnosis of pseudocarcinomatous hyperplasia. 7 Finally, while it is possible that a nested urothelial carcinoma could arise in a patient with a history of radiation therapy, in general nested urothelial carcinoma would lack the background changes of radiation therapy as well as the characteristic urothelial nests that ''wrap around'' vessels and fibrin thrombi so commonly seen in pseudocarcinomatous hyperplasia.…”

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confidence: 99%

Pseudocarcinomatous Hyperplasia of the Urinary Bladder

2014

Archives of Pathology &Amp; Laboratory Medicine

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We review the morphology and differential diagnoses of pseudocarcinomatous hyperplasia of the bladder, using a study case to illustrate the discussion. Pseudocarcinomatous hyperplasia is a rare, reactive response to an ischemic insult, classically to radiation therapy, and consists of proliferative, pseudoinfiltrative urothelial nests within the stroma. The presence of background radiation therapyrelated changes, such as numerous dilated thrombosed vessels, reactive-appearing endothelial and stromal cells, edema, and hemorrhage, can provide clues to the diagnosis. The main differential diagnoses include invasive urothelial carcinoma and the nested variant of urothelial carcinoma; morphologic features, such as the presence or absence of background therapy-related changes and the architecture and the cytologic atypia of the nests, can help distinguish between pseudocarcinomatous hyperplasia and urothelial carcinoma.

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Nested variant of urothelial carcinoma: a clinicopathologic and immunohistochemical study of 30 pure and mixed cases

Cited by 100 publications

References 26 publications

Rare Malign Tumors of Bladder: Review of the Literature

Rare Malign Tumors of Bladder: Review of the Literature

Inverted urothelial carcinoma: a series of 12 cases with a wide morphologic spectrum overlapping with the large nested variant

Pseudocarcinomatous Hyperplasia of the Urinary Bladder

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