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).

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.