Plasmacytoid urothelial carcinoma—diagnostic challenge in cytology

Molek, Koraljka Rajković; Seili-Bekafigo, Irena; Štemberger, Christophe; Jonjić, Nives; Đorđević, Gordana; Duletić-Načinović, Antica

doi:10.1002/dc.22867

Cited by 12 publications

(12 citation statements)

References 21 publications

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“…It is usually diagnosed at an advanced pathological stage, showing metastases in 60% of patients, and has a lower survival rate than conventional UC [2,3,4]. Few reports on the urine cytologic findings of PVUC exist in the literature [5,6,7,8,9], and there is only 1 case report of fine-needle aspiration (FNA) cytologic findings [10]. The diagnosis on FNA specimens can be challenging given its resemblance to plasma cells and typical lack of marked nuclear atypia.…”

Section: Introductionmentioning

confidence: 99%

Fine-Needle Aspiration Cytology of Metastatic Plasmacytoid Urothelial Carcinoma: Report of Four Cases Including a Case of Mixed Plasmacytoid and Micropapillary Morphology

Kao

Grignon³

2015

Acta Cytologica

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Objectives: The aim of this study was to report a small series of fine-needle aspiration (FNA) cytology of the plasmacytoid variant of urothelial carcinoma (PVUC). Study Design: A computerized search of our laboratory information system was performed for the 5-year period between January 2008 and January 2013 to identify all FNA cases in which the corresponding surgical pathology cases were diagnosed as PVUC. Results: The 4 cases identified were from 2 men (aged 56 and 64 years) and 2 women (aged 72 and 46 years). The FNA smears demonstrated low-to-moderate cellularity and consisted predominantly of single and dyshesive, medium-sized tumor cells with eccentrically located nuclei and a moderate-to-abundant dense cytoplasm. The nuclei were oval with slightly irregular nuclear membranes and contained coarse granular chromatin with inconspicuous or small nucleoli. There was moderate nuclear variation in size. The nuclear-to-cytoplasmic ratio ranged from <1 to 3. Binucleation, cytoplasmic vacuoles, and perinuclear hof were occasionally seen. Conclusions: FNA cytology of PVUC shares features with plasma cell neoplasms, lobular carcinoma of the breast, and signet ring cell carcinoma of the stomach. Being aware of the patient'sclinical history and the potentialdiagnostic pitfall of this rare variant of urothelial carcinoma is important for an accurate diagnosis on FNA biopsy.

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Section: Introductionmentioning

confidence: 99%

Fine-Needle Aspiration Cytology of Metastatic Plasmacytoid Urothelial Carcinoma: Report of Four Cases Including a Case of Mixed Plasmacytoid and Micropapillary Morphology

Kao

Grignon³

2015

Acta Cytologica

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“…Cytologic descriptions of plasmacytoid urothelial carcinoma have been published in the literature including descriptions of cerebrospinal fluid cytology [10], bladder washing [11] and urine cytology [7,10]. To our knowledge, we provide the first cytologic description of plasmacytoid urothelial carcinoma metastatic to the bone.…”

Section: Discussionmentioning

confidence: 99%

“…The boney metastasis demonstrated amphophilic cytoplasm with occasional inclusions and nuclei with conspicuous nucleoli. Other unique nuclear features included a description of irregular nuclear contours in the bladder washing sample [7,10,11]. …”

Section: Discussionmentioning

confidence: 99%

“…While CD138 is positive in up to 78% of plasmacytoid urothelial carcinomas, other lymphoid markers including CD20, CD45 and light chains are negative [10,11,12,13]. Evidence supporting the diagnosis of urothelial origin includes positivity for CK7, CK20 and GATA3.…”

Section: Discussionmentioning

confidence: 99%

“…Evidence supporting the diagnosis of urothelial origin includes positivity for CK7, CK20 and GATA3. Neural and muscle immunohistochemical markers are generally negative [4,10,11,12,14]. …”

Section: Discussionmentioning

confidence: 99%

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Metastatic Plasmacytoid Urothelial Carcinoma: A Case Report and Review of the Literature

Olsen¹,

Anderson²

2013

Acta Cytologica

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Plasmacytoid urothelial carcinoma is a rare form of invasive urothelial carcinoma first described in 1991 by Sahin et al. [Acta Cytol 1991;35:277-280]. Since this original publication, over 70 cases of plasmacytoid urothelial carcinoma have been described. A small number of cytologic descriptions have been published, including cases involving cerebrospinal fluid cytology, bladder washings and urine cytology. To our knowledge, we describe the first fine needle aspiration of metastatic plasmacytoid urothelial carcinoma in a 75-year-old man who presented with a pathologic fracture of the L4 vertebral body. One of the diagnostic pitfalls in the cytologic evaluation of this rare malignancy is the positive staining with CD138. While CD138 is a marker for plasma cell differentiation, it is also positive in plasmacytoid urothelial carcinoma. In addition to recognizing the cytomorphologic details, a full immunohistochemical panel is helpful in properly characterizing this entity. A brief discussion of long-term prognosis and treatment benefit is provided.

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A case report of urothelial carcinoma with combined micropapillary and plasmacytoid morphology in the urinary bladder

Park

Cho

Kim

2015

Diagnostic Cytopathology

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A case of combined micropapillary and plasmacytoid urothelial carcinoma (UC) of the urinary bladder is presented for a 74-year-old male who was admitted to the hospital with gross hematuria and multifocal papillary bladder tumors. Abdominal computed tomography showed a large enhancing mass on the left lateral and anterior wall of the urinary bladder, which was highly suspicious for extravesicular extension and focal extension of the anterior lesion to the pubic bone. In voided urine, cancer cells were scattered as micropapillae or nests as well as single cells on the low power view. On a higher power view, micropapillae or nests were composed of pleomorphic, high grade tumor cells with an inverted nuclear arrangement and with acinar structures occasionally identified. Single cells were discohesive and large with a thick cytoplasm and eccentrically located nuclei. Histologically, the tumor from the resected bladder showed diffusely infiltrating micropapillae or nests with a surrounding halo and dense singly-scattered plasmacytoid cells. Immunohistochemically, the cancer cells were positive for cytokeratin-7 and cytokeratin-20 but negative for S-100, leukocyte common antigen, and vimentin. At the time of radical cystectomy, severe adhesions and peritoneal metastases were found and the surgery was discontinued. The patient received systemic chemotherapy, but died of bladder cancer 14 months after surgery.

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Plasmacytoid urothelial carcinoma—diagnostic challenge in cytology

Cited by 12 publications

References 21 publications

Fine-Needle Aspiration Cytology of Metastatic Plasmacytoid Urothelial Carcinoma: Report of Four Cases Including a Case of Mixed Plasmacytoid and Micropapillary Morphology

Fine-Needle Aspiration Cytology of Metastatic Plasmacytoid Urothelial Carcinoma: Report of Four Cases Including a Case of Mixed Plasmacytoid and Micropapillary Morphology

Metastatic Plasmacytoid Urothelial Carcinoma: A Case Report and Review of the Literature

A case report of urothelial carcinoma with combined micropapillary and plasmacytoid morphology in the urinary bladder

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