Plasmacytoid urothelial carcinoma

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Plasmacytoid urothelial carcinoma, also plasmacytoid urothelial cell carcinoma and plasmacytoid variant of urothelial carcinoma, is a rare aggressive variant of urothelial carcinoma.

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

General

Features:[1]

Microscopic

Features:

  • Plasmacytoid morphology:
    • Abundant gray cytoplasm.
    • Eccentric nucleus - usually round, occasionally crescentic.
  • +/-Mucous (common).

DDx:

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.
    • In a series of 6 cases: 4 cases were 3+, one case was 2+, one case negative.[5]
    • HER2 status not a predictor of survival in UCC patients.[6]

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

  1. ↑ 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.
  2. ↑ 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.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ 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.
  6. ↑ 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.
  7. ↑ 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.
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