Nested urothelial carcinoma

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Nested urothelial cell carcinoma, also nested urothelial carcinoma, is an aggressive subtype of urothelial carcinoma that has a bland morphology but an aggressive behaviour.

It is also known as nested variant urothelial cell carcinoma.

General

  • Aggressive behaviour despite bland histomorphology.[1]

Microscopic

Features:[2]

  • High density of well-circumscribed nests.
  • Mild-to-moderate nuclear atypia.
  • +/-Foci of unequivocal conventional urothelial carcinoma.
    • Focally solid or gland fusion.
    • Moderate-to-severe nuclear atypia +/- abundant mitoses.
  • +/-Extension into the muscularis propria.

DDx:

IHC

  • MIB-1 typically >15%.[1]

See also

References

  1. 1.0 1.1 Lin, O.; Cardillo, M.; Dalbagni, G.; Linkov, I.; Hutchinson, B.; Reuter, VE. (Dec 2003). "Nested variant of urothelial carcinoma: a clinicopathologic and immunohistochemical study of 12 cases.". Mod Pathol 16 (12): 1289-98. doi:10.1097/01.MP.0000094091.04541.FC. PMID 14681330.
  2. Talbert, ML.; Young, RH. (May 1989). "Carcinomas of the urinary bladder with deceptively benign-appearing foci. A report of three cases.". Am J Surg Pathol 13 (5): 374-81. PMID 2712189.
  3. Cox, R.; Epstein, JI. (Sep 2011). "Large nested variant of urothelial carcinoma: 23 cases mimicking von Brunn nests and inverted growth pattern of noninvasive papillary urothelial carcinoma.". Am J Surg Pathol 35 (9): 1337-42. doi:10.1097/PAS.0b013e318222a653. PMID 21836490.