Premium
Microcystic urothelial carcinoma: morphology, immunohistochemistry and clinical behaviour
Author(s) -
Lopez Beltran Antonio,
Montironi Rodolfo,
Cheng Liang
Publication year - 2014
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12345
Subject(s) - immunohistochemistry , pathology , carcinoma , urothelial carcinoma , biopsy , urothelium , adenocarcinoma , stage (stratigraphy) , medicine , anatomical pathology , bladder cancer , urinary bladder , biology , cancer , paleontology
Aims To report on the clinicopathological features of 20 cases of microcystic urothelial bladder carcinoma. Methods and results The extent of microcystic component varied from 50–100% of the specimens. The cysts were round–oval and of varying sizes; the periphery of large cysts was frequently punctuated by many smaller cysts. The cysts were lined by urothelial, low columnar cells or by a single layer of flattened epithelium of low–intermediate nuclear grade. Focal high‐grade conventional urothelial carcinoma was present in eight cases. Immunohistochemistry demonstrated variable positivity for cytokeratins 7 and 20, MUC 1, MUC 5 AC , p63 and GATA 3. Extent of expression of K i67, p53 and p27 kip1 ranged from 20–60%, 10–40% and 10–30% of cells, respectively. On follow‐up, 11 patients died of disease at 11–56 months and three patients were alive with disease at 26–37 months. Univariate survival analysis showed no differences for microcystic carcinoma versus conventional urothelial carcinoma ( P = 0.548). Conclusions Microcystic urothelial carcinoma may pose diagnostic difficulties, especially in limited biopsy samples, where it may be mistaken for cystitis glandularis or adenocarcinoma of the bladder. Histological features, clinical history and appropriate immunohistochemical studies should help to distinguish it from its mimics. Aggressiveness seems to be related to higher stage at diagnosis.