Urine cytology of urothelial carcinoma with villoglandular differentiation

Mitra, Suvradeep; Chatterjee, Debajyoti; Gupta, Kirti; Radotra, Bishan Dass; Dey, Pranab

doi:10.1002/dc.23487

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…UCVGD is a rare variant of urothelial carcinoma. There are only two case series and two case reports of UCVGD in the English literature along with description of urine cytology in UCVGD 1–5. Small cell neuroendocrine carcinoma of bladder comprises <1% of all bladder tumours 6 7.…”

Section: Discussionmentioning

confidence: 99%

Urothelial carcinoma with villoglandular differentiation (UCVGD) with small cell neuroendocrine carcinoma of urinary bladder

Jha

Mitra²,

Adhya

et al. 2019

BMJ Case Rep

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Urothelial carcinoma with villoglandular differentiation (UCVGD) is a rare aggressive variant of urothelial carcinoma. It is usually associated with high-grade urothelial carcinoma or rarely adenocarcinoma. There is only one other previous report of UCVGD associated with small cell neuroendocrine carcinoma of urinary bladder. We report the second case of UCVGD with small cell neuroendocrine carcinoma of urinary bladder in a 74-year-old non-smoker male patient. The mass was muscle invasive and also invaded the prostate. This entity needs to be confidently diagnosed due to its prognostic and therapeutic implications.

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Section: Discussionmentioning

confidence: 99%

Urothelial carcinoma with villoglandular differentiation (UCVGD) with small cell neuroendocrine carcinoma of urinary bladder

Jha

Mitra²,

Adhya

et al. 2019

BMJ Case Rep

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“…Histomorphologically, this entity shows a divergent differentiation towards gastrointestinal epithelium resembling an intestinal adenomatous polyp coexisting with and intricately admixed with urothelial carcinoma. Most of the cases of UCVGD are reported to be associated with a high-grade component of urothelial carcinoma and are found to show lamina propria and/or detrusor muscle invasion, implying a poorer prognosis (1,(3)(4)(5). Villous adenoma is also a rare preneoplastic condition in the genitourinary tract and presumably arises from the cloacogenic remnant.…”

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confidence: 99%

Urothelial tumors with villous morphology: Histomorphology and role of immunohistochemistry in diagnosis

Mitra

Chatterjee

Das

et al. 2018

APMIS

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Villous adenoma and urothelial carcinoma with villoglandular differentiation (UCVGD) are rare urothelial tumours showing villous morphology, the former being a preneoplastic entity and the latter being a malignant one. The detailed immunohistochemistry of these entities is previously not described in the literature. Moreover, a limited biopsy sample of UCVGD or a villous adenoma with or without adenocarcinoma may be difficult to distinguish on the basis of the histomorphology alone. An immunohistochemical panel comprising of GATA3, p63, β-catenin, CK7 and CK20 was performed on five cases of UCVGD and three cases of villous adenoma with the aim of studying the expression of the proteins thereby aiding in the diagnosis of these entities in a limited surgical pathology specimen. The mean age of UCVGD was 66.8 years and all the patients were male. All the cases of UCVGD were associated with high grade papillary urothelial carcinoma with lamina propria invasion. The immunohistochemical panel showed strong nuclear GATA3 expression in the urothelial component of UCVGD. Interestingly, the high grade and the low grade villoglandular components of UCVGD also expressed GATA3 (nuclear) with a progressive loss of expression from the high grade to the low grade component. The villous adenomas showed negativity or aberrant cytoplasmic positivity for GATA3. The β-catenin showed a gradual loss of membranous expression from villous adenoma to low grade and high grade villoglandular components of UCVGD with a patchy membranous expression in the urothelial component of the UCVGD. p63 showed strong nuclear positivity in the urothelial component and uniform negativity in the villous adenoma and villoglandular component of UCVGD irrespective of its grade, thereby distinguishing the villoglandular component from the urothelial component. The urothelial component of UCVGD showed strong membranous CK7 expression and was higher than the CK20 expression in the urothelial component. In contrast, CK20 expression was higher in villous adenoma as compared to CK7. There was no difference in the expression of CK7 and CK20 in the villoglandular components and low grade and high grade villoglandular areas. The above-mentioned immunohistochemical pattern may help to distinguish the UCVGD from the villous adenoma.

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“…The identification of glandular morphology in urine sample is difficult and only a few anecdotal case reports are present exemplifying and documenting this issue. [31][32][33] Urine cytology of VA shows clusters of mucin-filled columnar cells. 33 The identification of both transitional epithelium with atypia and glandular epithelium should arouse suspicion of a UCVGD in urine cytology.…”

Section: Role Of Urine Cytologymentioning

confidence: 99%

Villous Morphology in Urinary Bladder Biopsy: An Approach to Diagnosis

2019

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Villous morphology in urinary bladder biopsy is a relatively uncommon finding. Villi are slender, finger-like structures that are commonly seen in the small intestine or in neoplastic lesions of gastrointestinal lineage/differentiation. Importantly, placenta also exhibits villi that are morphologically and functionally different from the intestinal one. Majority of the neoplastic lesions of urinary bladder are urothelial in origin with a minor subset showing glandular differentiation. While the presence of benign villi in urinary bladder biopsy necessitates a search for an occult perforation, provided a sample mismatch is ruled out, cytoarchitecturally abnormal/dysplastic villi indicate a neoplastic lesion of the urinary bladder encompassing villous adenoma and adenocarcinoma and urothelial carcinoma with villoglandular differentiation. The dysplastic villi in urinary bladder also imply a lower gastrointestinal endoscopy to rule out a colorectal primary. The development of the villous lesions in the urinary bladder and the colorectum are embryologically related and pose a major diagnostic challenge to the clinicians and surgical pathologists due to identical histomorphology and immunohistochemistry. We tend to discuss the morphological differentials and diagnostic approach to the villous lesions in the urinary bladder biopsy.

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Urine cytology of urothelial carcinoma with villoglandular differentiation

Cited by 5 publications

References 8 publications

Urothelial carcinoma with villoglandular differentiation (UCVGD) with small cell neuroendocrine carcinoma of urinary bladder

Urothelial carcinoma with villoglandular differentiation (UCVGD) with small cell neuroendocrine carcinoma of urinary bladder

Urothelial tumors with villous morphology: Histomorphology and role of immunohistochemistry in diagnosis

Villous Morphology in Urinary Bladder Biopsy: An Approach to Diagnosis

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