Difference between revisions of "Plasmacytoid urothelial carcinoma"

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'''Plasmacytoid urothelial carcinoma''' is a rare aggressive variant of [[urothelial carcinoma]].
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Plasmacytoid urothelial carcinoma -- very high mag.jpg
| Width      =
| Caption    = Plasmacytoid urothelial carcinoma
| Synonyms  = plasmacytoid urothelial cell carcinoma, plasmacytoid variant of urothelial carcinoma
| Micro      = plasmacytoid morphology (abundant gray cytoplasm; eccentrically placed (usually round) nucleus), +/-mucous (common), usually with conventional urothelial carcinoma
| Subtypes  = subtype of [[urothelial carcinoma]]
| LMDDx      = [[plasma cell neoplasm]], [[signet ring cell carcinoma]], [[mucinous adenocarcinoma]], [[invasive lobular carcinoma]]
| Stains    =
| IHC        = AE1/AE3 +ve, EMA +ve, CK7 +ve, CK20 +ve, CD138 +ve, p63 +ve/-ve
| EM        =
| Molecular  = CDH1 loss of function mutations
| IF        =
| Gross      =
| Grossing  = [[radical cystectomy grossing]], [[cystoprostatectomy grossing]], [[nephroureterectomy grossing]]
| Staging    = [[bladder cancer staging]]
| Site      = [[urothelium]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      = +/-hematuria
| Symptoms  =
| Prevalence = rare
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = poor
| Other      =
| ClinDDx    =
| Tx        = surgical excision, chemotherapy
}}
'''Plasmacytoid urothelial carcinoma''', also '''plasmacytoid urothelial cell carcinoma''' and '''plasmacytoid variant of urothelial carcinoma''', is a rare aggressive variant of [[urothelial carcinoma]].


==General==
==General==
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*Aggresive.
*Aggresive.
*Uncommon.
*Uncommon.
*Often associated with positive [[surgical margin|margin]]s (relative to other UCC variants); spreads along fascial planes.<ref name=pmid24582117>{{Cite journal  | last1 = Kaimakliotis | first1 = HZ. | last2 = Monn | first2 = MF. | last3 = Cheng | first3 = L. | last4 = Masterson | first4 = TA. | last5 = Cary | first5 = KC. | last6 = Pedrosa | first6 = JA. | last7 = Foster | first7 = RS. | last8 = Koch | first8 = MO. | last9 = Bihrle | first9 = R. | title = Plasmacytoid bladder cancer: variant histology with aggressive behavior and a new mode of invasion along fascial planes. | journal = Urology | volume = 83 | issue = 5 | pages = 1112-6 | month = May | year = 2014 | doi = 10.1016/j.urology.2013.12.035 | PMID = 24582117 }}</ref>
*Often associated with positive [[surgical margin|margin]]s (relative to other [[urothelial carcinoma]] variants); spreads along fascial planes.<ref name=pmid24582117>{{Cite journal  | last1 = Kaimakliotis | first1 = HZ. | last2 = Monn | first2 = MF. | last3 = Cheng | first3 = L. | last4 = Masterson | first4 = TA. | last5 = Cary | first5 = KC. | last6 = Pedrosa | first6 = JA. | last7 = Foster | first7 = RS. | last8 = Koch | first8 = MO. | last9 = Bihrle | first9 = R. | title = Plasmacytoid bladder cancer: variant histology with aggressive behavior and a new mode of invasion along fascial planes. | journal = Urology | volume = 83 | issue = 5 | pages = 1112-6 | month = May | year = 2014 | doi = 10.1016/j.urology.2013.12.035 | PMID = 24582117 }}</ref>


==Microscopic==
==Microscopic==
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**Eccentric nucleus - usually round, occasionally crescentic.
**Eccentric nucleus - usually round, occasionally crescentic.
*+/-Mucous (common).
*+/-Mucous (common).
DDx:
*[[Plasma cell neoplasm]].
*[[Signet ring cell carcinoma]].
*[[Mucinous adenocarcinoma]].
*[[Invasive lobular carcinoma]] of the breast.


===Images===
===Images===
www:
*[http://path.upmc.edu/cases/case267.html Plasmacytoid UCC - several images (upmc.edu)].
*[http://path.upmc.edu/cases/case267.html Plasmacytoid UCC - several images (upmc.edu)].
<gallery>
Image: Plasmacytoid urothelial carcinoma -- very low mag.jpg | Plasmacytoid UC - very low mag.
Image: Plasmacytoid urothelial carcinoma -- low mag.jpg | Plasmacytoid UC - low mag.
Image: Plasmacytoid urothelial carcinoma -- intermed mag.jpg | Plasmacytoid UC - intermed mag.
Image: Plasmacytoid urothelial carcinoma - alt - intermed mag.jpg | Plasmacytoid UC - intermed mag.
Image: Plasmacytoid urothelial carcinoma -- high mag.jpg | Plasmacytoid UC - high mag.
Image: Plasmacytoid urothelial carcinoma -- very high mag.jpg | Plasmacytoid UC - very high mag.
Image: Plasmacytoid urothelial carcinoma - alt -- very high mag.jpg | Plasmacytoid UC - very high mag.
</gallery>


==IHC==
==IHC==
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*AE1/AE3 +ve (16 +ve/16 cases).
*AE1/AE3 +ve (16 +ve/16 cases).
*EMA +ve (16 +ve/16 cases).
*EMA +ve (16 +ve/16 cases).
*CK7 +ve (16 +ve/16 cases).
*[[CK7]] +ve (16 +ve/16 cases).
*CK20 +ve (16 +ve/16 cases).
*[[CK20]] +ve (16 +ve/16 cases).
*CD138 (15 +ve/16 cases).
*[[CD138]] (15 +ve/16 cases).
*p63 (11 +ve/16 cases).
*p63 (11 +ve/16 cases).
Others:
*E-cadherin -ve (0 positive of 4 cases<ref name=pmid20818341>{{Cite journal  | last1 = Lim | first1 = MG. | last2 = Adsay | first2 = NV. | last3 = Grignon | first3 = DJ. | last4 = Osunkoya | first4 = AO. | title = E-cadherin expression in plasmacytoid, signet ring cell and micropapillary variants of urothelial carcinoma: comparison with usual-type high-grade urothelial carcinoma. | journal = Mod Pathol | volume = 24 | issue = 2 | pages = 241-7 | month = Feb | year = 2011 | doi = 10.1038/modpathol.2010.187 | PMID = 20818341 }}</ref>).
*HER2 +ve/-ve.
**In a series of 6 cases: 4 cases were 3+, one case was 2+, one case negative.<ref name=pmid27034533>{{Cite journal  | last1 = Kim | first1 = B. | last2 = Kim | first2 = G. | last3 = Song | first3 = B. | last4 = Lee | first4 = C. | last5 = Park | first5 = JH. | last6 = Moon | first6 = KC. | title = HER2 Protein Overexpression and Gene Amplification in Plasmacytoid Urothelial Carcinoma of the Urinary Bladder. | journal = Dis Markers | volume = 2016 | issue =  | pages = 8463731 | month =  | year = 2016 | doi = 10.1155/2016/8463731 | PMID = 27034533 }}</ref>
**HER2 status ''not'' a predictor of survival in UCC patients.<ref name=pmid25720673>{{Cite journal  | last1 = Bellmunt | first1 = J. | last2 = Werner | first2 = L. | last3 = Bamias | first3 = A. | last4 = Fay | first4 = AP. | last5 = Park | first5 = RS. | last6 = Riester | first6 = M. | last7 = Selvarajah | first7 = S. | last8 = Barletta | first8 = JA. | last9 = Berman | first9 = DM. | title = HER2 as a target in invasive urothelial carcinoma. | journal = Cancer Med | volume = 4 | issue = 6 | pages = 844-52 | month = Jun | year = 2015 | doi = 10.1002/cam4.432 | PMID = 25720673 }}</ref>
==Molecular==
*CDH1 loss of function - common.<ref name=pmid26901067>{{Cite journal  | last1 = Al-Ahmadie | first1 = HA. | last2 = Iyer | first2 = G. | last3 = Lee | first3 = BH. | last4 = Scott | first4 = SN. | last5 = Mehra | first5 = R. | last6 = Bagrodia | first6 = A. | last7 = Jordan | first7 = EJ. | last8 = Gao | first8 = SP. | last9 = Ramirez | first9 = R. | title = Frequent somatic CDH1 loss-of-function mutations in plasmacytoid variant bladder cancer. | journal = Nat Genet | volume =  | issue =  | pages =  | month = Feb | year = 2016 | doi = 10.1038/ng.3503 | PMID = 26901067 }}</ref>
==Sign out==
<pre>
Urinary Bladder Tumour, Transurtheral Resection:
- INVASIVE HIGH-GRADE UROTHELIAL CARCINOMA with plasmacytoid morphology.
-- Invasion into the muscularis propria.
-- Please see tumour summary.
</pre>


==See also==
==See also==

Latest revision as of 17:35, 17 August 2016

Plasmacytoid urothelial carcinoma
Diagnosis in short

Plasmacytoid urothelial carcinoma
Synonyms plasmacytoid urothelial cell carcinoma, plasmacytoid variant of urothelial carcinoma
LM plasmacytoid morphology (abundant gray cytoplasm; eccentrically placed (usually round) nucleus), +/-mucous (common), usually with conventional urothelial carcinoma
Subtypes subtype of urothelial carcinoma
LM DDx plasma cell neoplasm, signet ring cell carcinoma, mucinous adenocarcinoma, invasive lobular carcinoma
IHC AE1/AE3 +ve, EMA +ve, CK7 +ve, CK20 +ve, CD138 +ve, p63 +ve/-ve
Molecular CDH1 loss of function mutations
Grossing notes radical cystectomy grossing, cystoprostatectomy grossing, nephroureterectomy grossing
Staging bladder cancer staging
Site urothelium
Signs +/-hematuria
Prevalence rare
Prognosis poor
Treatment surgical excision, chemotherapy

Plasmacytoid urothelial carcinoma, also plasmacytoid urothelial cell carcinoma and plasmacytoid variant of urothelial carcinoma, is a rare aggressive variant of urothelial carcinoma.

General

Features:[1]

Microscopic

Features:

  • Plasmacytoid morphology:
    • Abundant gray cytoplasm.
    • Eccentric nucleus - usually round, occasionally crescentic.
  • +/-Mucous (common).

DDx:

Images

www:

  • Plasmacytoid UC - very low mag.

  • Plasmacytoid UC - low mag.

  • Plasmacytoid UC - intermed mag.

  • Plasmacytoid UC - intermed mag.

  • Plasmacytoid UC - high mag.

  • Plasmacytoid UC - very high mag.

  • Plasmacytoid UC - very high mag.

IHC

Features:[3]

  • AE1/AE3 +ve (16 +ve/16 cases).
  • EMA +ve (16 +ve/16 cases).
  • CK7 +ve (16 +ve/16 cases).
  • CK20 +ve (16 +ve/16 cases).
  • CD138 (15 +ve/16 cases).
  • p63 (11 +ve/16 cases).

Others:

  • E-cadherin -ve (0 positive of 4 cases[4]).
  • HER2 +ve/-ve.
    • In a series of 6 cases: 4 cases were 3+, one case was 2+, one case negative.[5]
    • HER2 status not a predictor of survival in UCC patients.[6]

Molecular

  • CDH1 loss of function - common.[7]

Sign out

Urinary Bladder Tumour, Transurtheral Resection:
- INVASIVE HIGH-GRADE UROTHELIAL CARCINOMA with plasmacytoid morphology.
-- Invasion into the muscularis propria.
-- Please see tumour summary.

See also

References

  1. ↑ Qin, M.; Wang, G.; Sun, Y.; He, Q.. "Plasmacytoid urothelial carcinoma of the bladder.". Indian J Pathol Microbiol 57 (2): 320-2. doi:10.4103/0377-4929.134730. PMID 24943778.
  2. ↑ Kaimakliotis, HZ.; Monn, MF.; Cheng, L.; Masterson, TA.; Cary, KC.; Pedrosa, JA.; Foster, RS.; Koch, MO. et al. (May 2014). "Plasmacytoid bladder cancer: variant histology with aggressive behavior and a new mode of invasion along fascial planes.". Urology 83 (5): 1112-6. doi:10.1016/j.urology.2013.12.035. PMID 24582117.
  3. ↑ Zhang, W.; Jiang, YX.; Liu, Y.; Yu, WJ.; Zhao, H.; Li, YJ. (Jul 2013). "[Plasmacytoid urothelial carcinoma of the urinary bladder: a clinicopathologic study of 16 cases].". Zhonghua Bing Li Xue Za Zhi 42 (7): 433-7. PMID 24246859.
  4. ↑ Lim, MG.; Adsay, NV.; Grignon, DJ.; Osunkoya, AO. (Feb 2011). "E-cadherin expression in plasmacytoid, signet ring cell and micropapillary variants of urothelial carcinoma: comparison with usual-type high-grade urothelial carcinoma.". Mod Pathol 24 (2): 241-7. doi:10.1038/modpathol.2010.187. PMID 20818341.
  5. ↑ Kim, B.; Kim, G.; Song, B.; Lee, C.; Park, JH.; Moon, KC. (2016). "HER2 Protein Overexpression and Gene Amplification in Plasmacytoid Urothelial Carcinoma of the Urinary Bladder.". Dis Markers 2016: 8463731. doi:10.1155/2016/8463731. PMID 27034533.
  6. ↑ Bellmunt, J.; Werner, L.; Bamias, A.; Fay, AP.; Park, RS.; Riester, M.; Selvarajah, S.; Barletta, JA. et al. (Jun 2015). "HER2 as a target in invasive urothelial carcinoma.". Cancer Med 4 (6): 844-52. doi:10.1002/cam4.432. PMID 25720673.
  7. ↑ Al-Ahmadie, HA.; Iyer, G.; Lee, BH.; Scott, SN.; Mehra, R.; Bagrodia, A.; Jordan, EJ.; Gao, SP. et al. (Feb 2016). "Frequent somatic CDH1 loss-of-function mutations in plasmacytoid variant bladder cancer.". Nat Genet. doi:10.1038/ng.3503. PMID 26901067.
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