Difference between revisions of "Plasmacytoid urothelial carcinoma"
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'''Plasmacytoid urothelial carcinoma''', also '''plasmacytoid urothelial cell carcinoma''', is a rare aggressive variant of [[urothelial carcinoma]]. | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Plasmacytoid urothelial carcinoma -- very high mag.jpg | |||
| Width = | |||
| Caption = Plasmacytoid urothelial carcinoma | |||
| Synonyms = plasmacytoid urothelial cell carcinoma, plasmacytoid variant of urothelial carcinoma | |||
| Micro = plasmacytoid morphology (abundant gray cytoplasm; eccentrically placed (usually round) nucleus), +/-mucous (common), usually with conventional urothelial carcinoma | |||
| Subtypes = subtype of [[urothelial carcinoma]] | |||
| LMDDx = [[plasma cell neoplasm]], [[signet ring cell carcinoma]], [[mucinous adenocarcinoma]], [[invasive lobular carcinoma]] | |||
| Stains = | |||
| IHC = AE1/AE3 +ve, EMA +ve, CK7 +ve, CK20 +ve, CD138 +ve, p63 +ve/-ve | |||
| EM = | |||
| Molecular = CDH1 loss of function mutations | |||
| IF = | |||
| Gross = | |||
| Grossing = [[radical cystectomy grossing]], [[cystoprostatectomy grossing]], [[nephroureterectomy grossing]] | |||
| Staging = [[bladder cancer staging]] | |||
| Site = [[urothelium]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = +/-hematuria | |||
| Symptoms = | |||
| Prevalence = rare | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = poor | |||
| Other = | |||
| ClinDDx = | |||
| Tx = surgical excision, chemotherapy | |||
}} | |||
'''Plasmacytoid urothelial carcinoma''', also '''plasmacytoid urothelial cell carcinoma''' and '''plasmacytoid variant of urothelial carcinoma''', is a rare aggressive variant of [[urothelial carcinoma]]. | |||
==General== | ==General== | ||
| Line 13: | Line 45: | ||
**Eccentric nucleus - usually round, occasionally crescentic. | **Eccentric nucleus - usually round, occasionally crescentic. | ||
*+/-Mucous (common). | *+/-Mucous (common). | ||
DDx: | |||
*[[Plasma cell neoplasm]]. | |||
*[[Signet ring cell carcinoma]]. | |||
*[[Mucinous adenocarcinoma]]. | |||
*[[Invasive lobular carcinoma]] of the breast. | |||
===Images=== | ===Images=== | ||
www: | |||
*[http://path.upmc.edu/cases/case267.html Plasmacytoid UCC - several images (upmc.edu)]. | *[http://path.upmc.edu/cases/case267.html Plasmacytoid UCC - several images (upmc.edu)]. | ||
<gallery> | |||
Image: Plasmacytoid urothelial carcinoma -- very low mag.jpg | Plasmacytoid UC - very low mag. | |||
Image: Plasmacytoid urothelial carcinoma -- low mag.jpg | Plasmacytoid UC - low mag. | |||
Image: Plasmacytoid urothelial carcinoma -- intermed mag.jpg | Plasmacytoid UC - intermed mag. | |||
Image: Plasmacytoid urothelial carcinoma - alt - intermed mag.jpg | Plasmacytoid UC - intermed mag. | |||
Image: Plasmacytoid urothelial carcinoma -- high mag.jpg | Plasmacytoid UC - high mag. | |||
Image: Plasmacytoid urothelial carcinoma -- very high mag.jpg | Plasmacytoid UC - very high mag. | |||
Image: Plasmacytoid urothelial carcinoma - alt -- very high mag.jpg | Plasmacytoid UC - very high mag. | |||
</gallery> | |||
==IHC== | ==IHC== | ||
| Line 21: | Line 69: | ||
*AE1/AE3 +ve (16 +ve/16 cases). | *AE1/AE3 +ve (16 +ve/16 cases). | ||
*EMA +ve (16 +ve/16 cases). | *EMA +ve (16 +ve/16 cases). | ||
*CK7 +ve (16 +ve/16 cases). | *[[CK7]] +ve (16 +ve/16 cases). | ||
*CK20 +ve (16 +ve/16 cases). | *[[CK20]] +ve (16 +ve/16 cases). | ||
*CD138 (15 +ve/16 cases). | *[[CD138]] (15 +ve/16 cases). | ||
*p63 (11 +ve/16 cases). | *p63 (11 +ve/16 cases). | ||
Others: | |||
*E-cadherin -ve (0 positive of 4 cases<ref name=pmid20818341>{{Cite journal | last1 = Lim | first1 = MG. | last2 = Adsay | first2 = NV. | last3 = Grignon | first3 = DJ. | last4 = Osunkoya | first4 = AO. | title = E-cadherin expression in plasmacytoid, signet ring cell and micropapillary variants of urothelial carcinoma: comparison with usual-type high-grade urothelial carcinoma. | journal = Mod Pathol | volume = 24 | issue = 2 | pages = 241-7 | month = Feb | year = 2011 | doi = 10.1038/modpathol.2010.187 | PMID = 20818341 }}</ref>). | |||
*HER2 +ve/-ve. | |||
**In a series of 6 cases: 4 cases were 3+, one case was 2+, one case negative.<ref name=pmid27034533>{{Cite journal | last1 = Kim | first1 = B. | last2 = Kim | first2 = G. | last3 = Song | first3 = B. | last4 = Lee | first4 = C. | last5 = Park | first5 = JH. | last6 = Moon | first6 = KC. | title = HER2 Protein Overexpression and Gene Amplification in Plasmacytoid Urothelial Carcinoma of the Urinary Bladder. | journal = Dis Markers | volume = 2016 | issue = | pages = 8463731 | month = | year = 2016 | doi = 10.1155/2016/8463731 | PMID = 27034533 }}</ref> | |||
**HER2 status ''not'' a predictor of survival in UCC patients.<ref name=pmid25720673>{{Cite journal | last1 = Bellmunt | first1 = J. | last2 = Werner | first2 = L. | last3 = Bamias | first3 = A. | last4 = Fay | first4 = AP. | last5 = Park | first5 = RS. | last6 = Riester | first6 = M. | last7 = Selvarajah | first7 = S. | last8 = Barletta | first8 = JA. | last9 = Berman | first9 = DM. | title = HER2 as a target in invasive urothelial carcinoma. | journal = Cancer Med | volume = 4 | issue = 6 | pages = 844-52 | month = Jun | year = 2015 | doi = 10.1002/cam4.432 | PMID = 25720673 }}</ref> | |||
==Molecular== | |||
*CDH1 loss of function - common.<ref name=pmid26901067>{{Cite journal | last1 = Al-Ahmadie | first1 = HA. | last2 = Iyer | first2 = G. | last3 = Lee | first3 = BH. | last4 = Scott | first4 = SN. | last5 = Mehra | first5 = R. | last6 = Bagrodia | first6 = A. | last7 = Jordan | first7 = EJ. | last8 = Gao | first8 = SP. | last9 = Ramirez | first9 = R. | title = Frequent somatic CDH1 loss-of-function mutations in plasmacytoid variant bladder cancer. | journal = Nat Genet | volume = | issue = | pages = | month = Feb | year = 2016 | doi = 10.1038/ng.3503 | PMID = 26901067 }}</ref> | |||
==Sign out== | |||
<pre> | |||
Urinary Bladder Tumour, Transurtheral Resection: | |||
- INVASIVE HIGH-GRADE UROTHELIAL CARCINOMA with plasmacytoid morphology. | |||
-- Invasion into the muscularis propria. | |||
-- Please see tumour summary. | |||
</pre> | |||
==See also== | ==See also== | ||
Latest revision as of 17:35, 17 August 2016
| Plasmacytoid urothelial carcinoma | |
|---|---|
| Diagnosis in short | |
 Plasmacytoid urothelial carcinoma | |
|
| |
| Synonyms | plasmacytoid urothelial cell carcinoma, plasmacytoid variant of urothelial carcinoma |
|
| |
| LM | plasmacytoid morphology (abundant gray cytoplasm; eccentrically placed (usually round) nucleus), +/-mucous (common), usually with conventional urothelial carcinoma |
| Subtypes | subtype of urothelial carcinoma |
| LM DDx | plasma cell neoplasm, signet ring cell carcinoma, mucinous adenocarcinoma, invasive lobular carcinoma |
| IHC | AE1/AE3 +ve, EMA +ve, CK7 +ve, CK20 +ve, CD138 +ve, p63 +ve/-ve |
| Molecular | CDH1 loss of function mutations |
| Grossing notes | radical cystectomy grossing, cystoprostatectomy grossing, nephroureterectomy grossing |
| Staging | bladder cancer staging |
| Site | urothelium |
|
| |
| Signs | +/-hematuria |
| Prevalence | rare |
| Prognosis | poor |
| Treatment | surgical excision, chemotherapy |
Plasmacytoid urothelial carcinoma, also plasmacytoid urothelial cell carcinoma and plasmacytoid variant of urothelial carcinoma, is a rare aggressive variant of urothelial carcinoma.
General
Features:[1]
- Aggresive.
- Uncommon.
- Often associated with positive margins (relative to other urothelial carcinoma variants); spreads along fascial planes.[2]
Microscopic
Features:
- Plasmacytoid morphology:
- Abundant gray cytoplasm.
- Eccentric nucleus - usually round, occasionally crescentic.
- +/-Mucous (common).
DDx:
- Plasma cell neoplasm.
- Signet ring cell carcinoma.
- Mucinous adenocarcinoma.
- Invasive lobular carcinoma of the breast.
Images
www:
Plasmacytoid UC - very low mag.
Plasmacytoid UC - low mag.
Plasmacytoid UC - intermed mag.
Plasmacytoid UC - intermed mag.
Plasmacytoid UC - high mag.
Plasmacytoid UC - very high mag.
Plasmacytoid UC - very high mag.
IHC
Features:[3]
- AE1/AE3 +ve (16 +ve/16 cases).
- EMA +ve (16 +ve/16 cases).
- CK7 +ve (16 +ve/16 cases).
- CK20 +ve (16 +ve/16 cases).
- CD138 (15 +ve/16 cases).
- p63 (11 +ve/16 cases).
Others:
- E-cadherin -ve (0 positive of 4 cases[4]).
- HER2 +ve/-ve.
Molecular
- CDH1 loss of function - common.[7]
Sign out
Urinary Bladder Tumour, Transurtheral Resection: - INVASIVE HIGH-GRADE UROTHELIAL CARCINOMA with plasmacytoid morphology. -- Invasion into the muscularis propria. -- Please see tumour summary.
See also
References
- ↑ Qin, M.; Wang, G.; Sun, Y.; He, Q.. "Plasmacytoid urothelial carcinoma of the bladder.". Indian J Pathol Microbiol 57 (2): 320-2. doi:10.4103/0377-4929.134730. PMID 24943778.
- ↑ Kaimakliotis, HZ.; Monn, MF.; Cheng, L.; Masterson, TA.; Cary, KC.; Pedrosa, JA.; Foster, RS.; Koch, MO. et al. (May 2014). "Plasmacytoid bladder cancer: variant histology with aggressive behavior and a new mode of invasion along fascial planes.". Urology 83 (5): 1112-6. doi:10.1016/j.urology.2013.12.035. PMID 24582117.
- ↑ Zhang, W.; Jiang, YX.; Liu, Y.; Yu, WJ.; Zhao, H.; Li, YJ. (Jul 2013). "[Plasmacytoid urothelial carcinoma of the urinary bladder: a clinicopathologic study of 16 cases].". Zhonghua Bing Li Xue Za Zhi 42 (7): 433-7. PMID 24246859.
- ↑ Lim, MG.; Adsay, NV.; Grignon, DJ.; Osunkoya, AO. (Feb 2011). "E-cadherin expression in plasmacytoid, signet ring cell and micropapillary variants of urothelial carcinoma: comparison with usual-type high-grade urothelial carcinoma.". Mod Pathol 24 (2): 241-7. doi:10.1038/modpathol.2010.187. PMID 20818341.
- ↑ Kim, B.; Kim, G.; Song, B.; Lee, C.; Park, JH.; Moon, KC. (2016). "HER2 Protein Overexpression and Gene Amplification in Plasmacytoid Urothelial Carcinoma of the Urinary Bladder.". Dis Markers 2016: 8463731. doi:10.1155/2016/8463731. PMID 27034533.
- ↑ Bellmunt, J.; Werner, L.; Bamias, A.; Fay, AP.; Park, RS.; Riester, M.; Selvarajah, S.; Barletta, JA. et al. (Jun 2015). "HER2 as a target in invasive urothelial carcinoma.". Cancer Med 4 (6): 844-52. doi:10.1002/cam4.432. PMID 25720673.
- ↑ Al-Ahmadie, HA.; Iyer, G.; Lee, BH.; Scott, SN.; Mehra, R.; Bagrodia, A.; Jordan, EJ.; Gao, SP. et al. (Feb 2016). "Frequent somatic CDH1 loss-of-function mutations in plasmacytoid variant bladder cancer.". Nat Genet. doi:10.1038/ng.3503. PMID 26901067.