Plasmacytoid urothelial carcinoma

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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]

Microscopic

Features:

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

DDx:

Images

www:

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).

Molecular

  • CDH1 loss of function - common.[4]

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. 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.