Case 26

Provided clinical history

62 year old man, bladder tumour

Site

Urinary bladder

Primary image

Low magnification. H&E stain.

Intermediate magnification
Intermediate magnification. H&E stain.

Very high magnification
Very high magnification. H&E stain.

Differential diagnosis

Differential diagnosis
urothelial carcinoma microcystic and nested variants, prostatic adenocarcinoma, clear cell adenocarcinoma

Additional tests

More history

More history
No history of bladder cancer. PSA normal.

Ask a colleague

Ask a colleague
Looks glandular.

Stains

Alcian blue/PAS to Bilirubin Test Result Alcian blue/PAS Dr Torres would ask why! Alican blue pH 1.0 Dr Torres would ask why! Alcian blue pH 2.5 Dr Torres would ask why! Auramine Dr Torres would ask why! Bielchowsky Dr Torres would ask why! Bilirubin Dr Torres would ask why!	Colloidal iron to Fontana-Masson Test Result Colloidal iron Dr Torres would ask why! Congo red Dr Torres would ask why! Cresyl violet Dr Torres would ask why! Dieterle Dr Torres would ask why! Diff Quik Dr Torres would ask why! Fontana-Masson Dr Torres would ask why!	Gallyas to Gremelius Test Result Gallyas Dr Torres would ask why! Giemsa Dr Torres would ask why! GMS Dr Torres would ask why! Gomori's trichrome Dr Torres would ask why! Gram Dr Torres would ask why! Gremelius Dr Torres would ask why!	JMS to Mucicarmine Test Result JMS Dr Torres would ask why! Jones Dr Torres would ask why! Kinyoun Dr Torres would ask why! Luxol fast blue Dr Torres would ask why! Masson trichrome Dr Torres would ask why! M-MAS Dr Torres would ask why! Movat Dr Torres would ask why! Mucicarmine Dr Torres would ask why!	Oil red O to Prussian blue Test Result Oil red O Dr Torres would ask why! Orecein Dr Torres would ask why! PAS Dr Torres would ask why! PASD Dr Torres would ask why! PASF Dr Torres would ask why! PTAH Dr Torres would ask why! Prussian blue Dr Torres would ask why!	Reticulin to Ziehl-Neelsen Test Result Reticulin Dr Torres would ask why! Sudan black B Dr Torres would ask why! Toluidine blue Dr Torres would ask why! Verhoeff Dr Torres would ask why! Von Kossa Dr Torres would ask why! Warthin-Starry Dr Torres would ask why! Ziehl-Neeslen Dr Torres would ask why!

IHC

Alpha-1 AT to Cathepsin K Test Result alpha-1 AT ACTH AE1/AE1 alpha-fetoprotein Alk-I AMACR -ve AR ATRX Beta2-microglobulin B72.3 Beta-catenin BCL2 BCL6 BCLxL C3 comp CA9 Calcitonin Calponin Calretinin CAM5.2 Cathepsin K	CD10 to Chromogranin Test Result CD10 CD117 CD138 CD15 CD1a CD20 CD21 CD23 CD3 CD30 CD31 CD34 CD35 CD4 CD43 CD45 (LCA) CD5 CD56 CD57 CD68 CD7 +ve CD79a CD8 CD99 CDX2 CEA-m -ve Chromogranin	CK17 to Glypican 3 Test Result CK17 CK19 CK20 CK34betaE12 CK5/6 CK7 CMV c-MYC Cyclin D1 D2-40 Desmin DOG1 EBV EMA ER and PR Factor VIII Factor XIIIa Fascin FH FSH Gastrin GATA3 GCDFP-15 (BRST2) GFAP GH Glucagon Glypican-3	HBME-1 to IgM Test Result HBME-1 HBV core HBV surface H-caldesmon HCG Helicobacter Hepatocyte HER2/neu HHV-8 HMB-45 HNF1beta HPV HSV-I HSV-II IDH-1 Inhibin INI1 (BAF47) Insulin Kappa Ki-67 <5% Lambda Leu 7 IgA IgG IgM	LH to PDGFR Test Result LH LIN28 Lysozyme mammoglobin MAP2 MCV Melanin A MHC class I MITF MUM1 Myeloperoxidase MYO D1 Myoglobin Napsin NF NKX3.1 NSE OCT3/4 p16 P501S p53 -ve p57 p63 Pankeratin PAX2 +ve PAX5 PAX8 +ve PCNA PDGFR	PLAP to WT1 Test Result PLAP PNL-2C Prolactin PSA -ve PSAP -ve RCC S-100 SALL4 Smooth muscle actin Somatostatin STAT6 Synaptophysin TdT TFE3 TFEB Thyroglobulin Toxoplasma TSH TTF-1 Ubiquitin UCHL1 (PGP9.5) Ulex Europaeus Vimentin VIP VZV WT-1

Chromosomal translocations

Translocations Chr 1-10 Test Result t(1;13) PAX7-FKHR Dr Torres would ask why! t(2,13) PAX3-FKHR Dr Torres would ask why! t(8;14) MYC-IGH Dr Torres would ask why! t(9;22) BCR-ABL Dr Torres would ask why! t(9;22) CHN-EWS Dr Torres would ask why!	Translocations Chr 11-13 Test Result t(11;14) CCND1-IGH Dr Torres would ask why! t(11;22) EWS-WT1 Dr Torres would ask why! t(11;22) FLI1-EWS Dr Torres would ask why! t(12;15) ETV6-NTRK3 Dr Torres would ask why! t(12;16) FUS-ATF1 Dr Torres would ask why! t(12;16) CHOP-TLS Dr Torres would ask why! t(12;22) EWS-ATF1 Dr Torres would ask why!	Translocations Chr 14-22 Test Result t(14,18) IGH-BCL2 Dr Torres would ask why! t(15;17) PML-RARA Dr Torres would ask why! t(16;21) FUS-ERG Dr Torres would ask why! t(17;22) COLA1-PDGFB Dr Torres would ask why! t(21;22) EWS-ERG Dr Torres would ask why!	Translocations Chr X & Y Test Result t(X;1) PRCC-TFE3 Dr Torres would ask why! t(X;17) TFE3-ASPL Dr Torres would ask why! t(X;18) SYT-SSX Dr Torres would ask why!

Diagnosis

Diagnosis
Mesonephric adenoma