Case 26

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Provided clinical history

62 year old man, bladder tumour

Site

Urinary bladder

Primary image

Nephrogenic adenoma - low mag.jpg
Low magnification. H&E stain.
Intermediate magnification 
Nephrogenic adenoma - intermed mag.jpg
Intermediate magnification. H&E stain.
Very high magnification 
Nephrogenic adenoma - very high mag.jpg
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/PASDr Torres would ask why!
Alican blue pH 1.0Dr Torres would ask why!
Alcian blue pH 2.5Dr Torres would ask why!
AuramineDr Torres would ask why!
BielchowskyDr Torres would ask why!
BilirubinDr Torres would ask why!
Colloidal iron to Fontana-Masson
Test Result
Colloidal ironDr Torres would ask why!
Congo redDr Torres would ask why!
Cresyl violetDr Torres would ask why!
DieterleDr Torres would ask why!
Diff QuikDr Torres would ask why!
Fontana-MassonDr Torres would ask why!
Gallyas to Gremelius
Test Result
GallyasDr Torres would ask why!
GiemsaDr Torres would ask why!
GMSDr Torres would ask why!
Gomori's trichromeDr Torres would ask why!
GramDr Torres would ask why!
GremeliusDr Torres would ask why!
JMS to Mucicarmine
Test Result
JMSDr Torres would ask why!
JonesDr Torres would ask why!
KinyounDr Torres would ask why!
Luxol fast blueDr Torres would ask why!
Masson trichromeDr Torres would ask why!
M-MASDr Torres would ask why!
MovatDr Torres would ask why!
MucicarmineDr Torres would ask why!
Oil red O to Prussian blue
Test Result
Oil red ODr Torres would ask why!
OreceinDr Torres would ask why!
PASDr Torres would ask why!
PASDDr Torres would ask why!
PASFDr Torres would ask why!
PTAHDr Torres would ask why!
Prussian blueDr Torres would ask why!
Reticulin to Ziehl-Neelsen
Test Result
ReticulinDr Torres would ask why!
Sudan black BDr Torres would ask why!
Toluidine blueDr Torres would ask why!
VerhoeffDr Torres would ask why!
Von KossaDr Torres would ask why!
Warthin-StarryDr Torres would ask why!
Ziehl-NeeslenDr 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
CD79a
CD8
CD99
CDX2
CEA-m -ve
Chromogranin
CK17 to Glypican 3
Test Result
CK17
CK19
CK20
CK34betaE12
CK5/6
CK7 +ve
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-IGHDr 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-TFE3Dr 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


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