Lymphoepithelioma-like carcinoma of the urinary bladder

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Lymphoepithelioma-like carcinoma of the urinary bladder, also urinary bladder lymphoepithelioma-like carcinoma (abbreviated UBLELC), is a rare variant of urothelial carcinoma.[1]

Lymphoepithelioma-like carcinoma of the urinary bladder
Diagnosis in short

Urinary bladder lymphoepithelioma-like carcinoma. H&E stain.
LM squamoid cells with abundant dense cytoplasm central nuclei +/- small/indistinct nucleoli, prominent lymphoid infiltrate
Subtypes (subtype of urothelial carcinoma)
LM DDx lymphoma, urothelial carcinoma and inflammation, metastatic lymphoepithelioma-like carcinoma
IHC CK34betaE12 +ve, p63 +ve/-ve, CK7 +ve/-ve, CK20 -ve, CD30 -ve
Site urinary bladder - see urothelium
Prevalence rare
Prognosis favourable on limited data
Other not associated with EBV

General

  • Rare.
  • Not associated with EBV.[2]
  • Good prognosis on scant data[3] - possibly poor if metastatic.

Microscopic

Features:

  • Clusters of (cohesive) squamoid cells with:
    • Abundant dense cytoplasm.
    • Central nuclei +/- small/indistinct nucleoli.
  • Prominent lymphoid infiltrate - key feature.
  • +/-Urothelial carcinoma in situ.

Note:

  • Peritumoural lymphoid aggregates are typical.[4]

DDx:

Images

  • UBLELC - low mag. (WC)

  • UBLELC - intermed. mag. (WC)

  • UBLELC - intermed. mag. (WC)

  • UBLELC - high mag. (WC)

  • UBLELC - very high mag. (WC)

www:

IHC

Features:[2]

  • p53 +ve/-ve. (+ve in ~60% of cases).
  • CK34betaE12 +ve (+ve in ~75% of cases).
  • CK7 +ve/-ve (+ve in ~60% of cases).
  • p63 +ve/-ve (+ve in ~50% of cases).

Others:[2]

  • CK20 -ve.
  • TTF-1 -ve.
  • CD30 -ve.

See also

References

  1. ↑ Amin, MB. (Jun 2009). "Histological variants of urothelial carcinoma: diagnostic, therapeutic and prognostic implications.". Mod Pathol 22 Suppl 2: S96-S118. doi:10.1038/modpathol.2009.26. PMID 19494856.
  2. ↑ 2.0 2.1 2.2 Williamson, SR.; Zhang, S.; Lopez-Beltran, A.; Shah, RB.; Montironi, R.; Tan, PH.; Wang, M.; Baldridge, LA. et al. (Apr 2011). "Lymphoepithelioma-like carcinoma of the urinary bladder: clinicopathologic, immunohistochemical, and molecular features.". Am J Surg Pathol 35 (4): 474-83. doi:10.1097/PAS.0b013e31820f709e. PMID 21383609.
  3. ↑ Fujino, T.; Kubota, M.; Nishiyama, R.; Kanno, T.; Okada, T.; Higashi, Y.; Yamada, H.; Okamoto, E. (Oct 2014). "[A case of lymphoepithelioma-like carcinoma of the bladder].". Hinyokika Kiyo 60 (10): 507-11. PMID 25391783.
  4. ↑ 4.0 4.1 4.2 Singh, NG.; Mannan, AA.; Rifaat, AA.; Kahvic, M.. "Lymphoepithelioma-like carcinoma of the urinary bladder: report of a rare case.". Ann Saudi Med 29 (6): 478-81. doi:10.4103/0256-4947.57173. PMID 19847088.
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