Micropapillary urothelial carcinoma

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Micropapillary urothelial carcinoma
Diagnosis in short

Urothelial carcinoma with invasive micropapillary features. H&E stain.

LM nests of tumour cells with clefting to the surrounding stroma (invasive pattern)
Subtypes (subtype of urothelial carcinoma)
LM DDx conventional urothelial carcinoma, other micropapillary carcinomas (metastases)
IHC CK7 +ve, CK20 +ve/-ve, GATA3 +ve, p63 -ve/+ve
Grossing notes radical cystectomy grossing, cystoprostatectomy grossing, nephroureterectomy grossing
Staging bladder cancer staging
Site urothelium - urinary bladder, ureter, renal pelvis, urethra (males)

Signs hematuria (typical presentation)
Prevalence rare
Prognosis poor (aggressive course)
Treatment cystectomy/cytoprostatectomy - advocated for cT1 disease by some

Micropapillary urothelial carcinoma (abbreviated MPUC), also micropapillary urothelial cell carcinoma (abbreviated MPUCC), is an aggressive variant of urothelial carcinoma.[1]

General

Treatment:

  • cT1 disease treated by radical cystectomy in some centres.[3]

Microscopic

Features:[1]

  • Micropapillae - definitional.
    • Nipple-like structures without fibrovascular cores.
    • Quantity of micropapillary pattern (percentage) is variable.[2]
  • Conventional urothelial carcinoma (typical).

Note:

DDx:

  • Metastasis (breast, ovary, lung, pancreas, salivary gland).

Images

Case 1

Case 2

www

IHC

Features:

Others:[4]

  • p63 -ve/+ve.
  • p40 -ve/+ve.

Sign out

  • Report percentage of micropapillary pattern - suggested.[citation needed]
  • It is suggested that one distinction between invasive and non-invasive micropapillary pattern.[5]

See also

References

  1. 1.0 1.1 1.2 Compérat, E.; Roupret, M.; Yaxley, J.; Reynolds, J.; Varinot, J.; Ouzaïd, I.; Cussenot, O.; Samaratunga, H. (Dec 2010). "Micropapillary urothelial carcinoma of the urinary bladder: a clinicopathological analysis of 72 cases.". Pathology 42 (7): 650-4. doi:10.3109/00313025.2010.522173. PMID 21080874.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Chatterjee, D.; Das, A.; Radotra, BD.. "Invasive micropapillary carcinoma of urinary bladder: a clinicopathological study.". Indian J Pathol Microbiol 58 (1): 2-6. doi:10.4103/0377-4929.151153. PMID 25673582.
  3. Willis, DL.; Fernandez, MI.; Dickstein, RJ.; Parikh, S.; Shah, JB.; Pisters, LL.; Guo, CC.; Henderson, S. et al. (Apr 2015). "Clinical outcomes of cT1 micropapillary bladder cancer.". J Urol 193 (4): 1129-34. doi:10.1016/j.juro.2014.09.092. PMID 25254936.
  4. 4.0 4.1 Lin, X.; Zhu, B.; Villa, C.; Zhong, M.; Kundu, S.; Rohan, SM.; Yang, XJ. (Sep 2014). "The utility of p63, p40, and GATA-binding protein 3 immunohistochemistry in diagnosing micropapillary urothelial carcinoma.". Hum Pathol 45 (9): 1824-9. doi:10.1016/j.humpath.2014.04.015. PMID 24993315.
  5. Amin, A.; Epstein, JI. (Dec 2012). "Noninvasive micropapillary urothelial carcinoma: a clinicopathologic study of 18 cases.". Hum Pathol 43 (12): 2124-8. doi:10.1016/j.humpath.2012.04.013. PMID 22939957.