High-grade Urothelial Carcinoma with Malignant Melanocytic Differentiation

2021 ◽  
pp. 106689692110004
Author(s):  
Hongzhi Xu ◽  
Elizabeth M. Genega ◽  
Liyan Zhuang ◽  
Ming Zhou
Keyword(s):  
Urothelial Carcinoma ◽  
Bladder Wall ◽  
Minor Component ◽  
Asian Woman ◽  
High Grade ◽  
Therapeutic Implications ◽  
Divergent Differentiation ◽  
Rare Cells ◽  
A Minor ◽  
Melanocytic Differentiation

Urothelial carcinoma usually shows divergent differentiation and variant histology with squamous and glandular morphology being most common. In this report, we present a case of divergent malignant melanocytic differentiation in a high-grade urothelial carcinoma. A 98-year-old East Asian woman with an anterior bladder wall mass underwent resection, which revealed a high-grade poorly differentiated tumor. A minor component of high-grade papillary urothelial carcinoma and carcinoma in situ is also present. The majority of the tumor cells are morphologically and immunohistochemically consistent with melanoma, a minority of cells are positive for urothelial markers, and rare cells coexpress both melanocytic and urothelial markers. Cells that express melanocytic markers or urothelial markers are intimately admixed together. Taken together, a diagnosis of high-grade urothelial carcinoma with malignant melanocytic differentiation was rendered. This is the first report in the literature of malignant melanocytic differentiation in a high-grade urothelial carcinoma, a finding that may have important diagnostic and therapeutic implications.

scholarly journals Hypercalcemia in Upper Urinary Tract Urothelial Carcinoma: A Case Report and Literature Review

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Keiko Asao ◽  
Jonathan B. McHugh ◽  
David C. Miller ◽  
Nazanene H. Esfandiari
Keyword(s):  
Parathyroid Hormone ◽  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Upper Urinary Tract ◽  
Therapeutic Implications ◽  
Dihydroxyvitamin D ◽  
1,25 Dihydroxyvitamin D ◽  
Divergent Differentiation ◽  
Parathyroid Hormone Related Peptide ◽  
Urinary Tract Urothelial Carcinoma

Objective. We here report a patient with upper urinary tract urothelial carcinoma with hypercalcemia likely due to elevated 1,25-dihydroxyvitamin D.Methods. We present a clinical case and a summary of literature search.Results. A 57-year-old man, recently diagnosed with a left renal mass, for which a core biopsy showed renal cell carcinoma, was admitted for hypercalcemia of 11.0 mg/mL He also had five small right lung nodules with a negative bone scan. Both intact parathyroid hormone and parathyroid hormone-related peptide were appropriately low, and 1,25-dihydroxyvitamin D was elevated at 118 pg/dL. The patient’s calcium was normalized after hydration, and he underwent radical nephrectomy. On the postoperative day 6, a repeat 1,25-dihydroxyvitamin D was 24 pg/mL with a calcium of 8.1 mg/dL. Pathology showed a 6 cm high-grade urothelial carcinoma with divergent differentiation. We identified a total of 27 previously reported cases with hypercalcemia and upper tract urothelial carcinoma in English. No cases have a documented elevated 1,25-dihydroxyvitamin D level.Conclusion. This clinical course suggests that hypercalcemia in this case is from the patient’s tumor, which was likely producing 1,25-dihydroxyvitamin D. Considering the therapeutic implications, hypercalcemia in patients with upper urinary tract urothelial carcinoma should be evaluated with 1,25-dihydroxyvitamin D.

scholarly journals Urothelial carcinoma with villoglandular differentiation (UCVGD) with small cell neuroendocrine carcinoma of urinary bladder

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-228017 ◽  
Author(s):  
Shilpy Jha ◽  
Suvradeep Mitra ◽  
Amit Kumar Adhya ◽  
Prasant Nayak
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Male Patient ◽  
Neuroendocrine Carcinoma ◽  
Small Cell ◽  
High Grade ◽  
Small Cell Neuroendocrine Carcinoma ◽  
Therapeutic Implications ◽  
Muscle Invasive ◽  
Aggressive Variant

Urothelial carcinoma with villoglandular differentiation (UCVGD) is a rare aggressive variant of urothelial carcinoma. It is usually associated with high-grade urothelial carcinoma or rarely adenocarcinoma. There is only one other previous report of UCVGD associated with small cell neuroendocrine carcinoma of urinary bladder. We report the second case of UCVGD with small cell neuroendocrine carcinoma of urinary bladder in a 74-year-old non-smoker male patient. The mass was muscle invasive and also invaded the prostate. This entity needs to be confidently diagnosed due to its prognostic and therapeutic implications.

scholarly journals Impact of divergent differentiation in urothelial carcinoma on oncological outcome in patients with T1 high-grade bladder cancer

2017 ◽  
Vol 47 (6) ◽  
pp. 560-567 ◽  
Author(s):  
Nakanori Fujii ◽  
Yoshinobu Hoshii ◽  
Hiroshi Hirata ◽  
Junichi Mori ◽  
Kosuke Shimizu ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urothelial Carcinoma ◽  
Oncological Outcome ◽  
High Grade ◽  
Divergent Differentiation

Significance of a minor high-grade component in a low-grade noninvasive papillary urothelial carcinoma of bladder

2016 ◽  
Vol 47 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Leonardo O. Reis ◽  
Diana Taheri ◽  
Alcides Chaux ◽  
Gunes Guner ◽  
Maria A. Mendoza Rodriguez ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Low Grade ◽  
High Grade ◽  
Papillary Urothelial Carcinoma ◽  
A Minor ◽  
Urothelial Carcinoma Of Bladder

A Contemporary Clinicopathologic Analysis of Primary Urothelial Carcinoma of the Urethra Without Concurrent Renal Pelvic, Ureteral, or Bladder Carcinoma

2021 ◽  
pp. 106689692110324
Author(s):  
Fengming Chen ◽  
Shreyas Joshi ◽  
Bradley C. Carthon ◽  
Adeboye O. Osunkoya
Keyword(s):  
Urothelial Carcinoma ◽  
Renal Pelvis ◽  
Previous History ◽  
Low Grade ◽  
High Grade ◽  
Divergent Differentiation ◽  
History Of ◽  
Variant Histology

Primary urothelial carcinoma (UCa) of the urethra is relatively uncommon, and the underlying pathogenesis has not been well characterized, especially in the absence of concurrent UCa at other sites. A search for cases of primary UCa of the urethra was conducted. Patients with concurrent UCa of the renal pelvis, ureter, or bladder at the time of diagnosis of the primary tumor were excluded. Clinicopathologic and follow-up data were obtained. A total of 35 cases from 30 patients (27 male and 3 female) were included in the study. The mean patient age at the initial diagnosis was 71 years (range: 41-90 years). Cases were composed of high-grade UCa (26 of 35 = 74%), low-grade UCa (4 of 35 = 11%), and UCa in situ (5 of 35 = 14%). Invasion was present in 14 of 26 (54%) cases of high-grade UCa. Interestingly, 23 of 30 (77%) patients had a previous history of UCa including 7 (30%) cases with divergent differentiation or variant histology. Follow-up data were available in 23 patients with a mean duration of 26.7 months (range: 0.6-87 months). Eleven patients (31%) died of metastatic UCa. This is one of the largest studies to date of primary UCa of the urethra without concurrent UCa of the renal pelvis, ureter, or bladder. Previous history of UCa of the bladder, especially with divergent differentiation or variant histology is conceivably a key risk factor for developing subsequent primary UCa of the urethra. These findings are important for the development of surveillance protocols and therapeutic strategies.

scholarly journals Various Histomorphologic Patterns of Urothelial Carcinoma in TURBT Specimen

Esculapio ◽  
2021 ◽  
Vol 16 (4 (oct 2020 - dec 2020)) ◽  
Author(s):  
Hira Kareem ◽  
Amna Jahan ◽  
Iram Nadeem ◽  
Samra Sameen ◽  
Rajia Liaqat ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Transurethral Resection ◽  
Age Groups ◽  
Neuroendocrine Differentiation ◽  
Clinical Implications ◽  
High Grade ◽  
Histological Variants ◽  
Divergent Differentiation ◽  
Resection Specimen ◽  
Nested Variant

Objective: To evaluate the various morphologic patterns of urothelial carcinoma in transurethral resection specimen of urinary bladder. Method: One hundred ninty three biopsies of transurethral resection of bladder from different age groups without exception of sex and race were included in this study from year 2013-2019 in Services Hospital Lahore. Result: Eighty-eight cases from 193 biopsies from services hospital Lahore in 2013 to 2019 were reported as high-grade urothelial carcinoma. While 52out of 193 cases were diagnosed as nested variant of urothelial carcinoma.03 cases neuroendocrine differentiation of urothelial carcinoma is identified and 21 cases having squamous and 12 cases with sarcomatoid differentiation of urothelial carcinoma is reported. Conclusion: Urothelial carcinoma has many histological variants each having different prognosis and clinical implications. So accurate subtyping of the tumor is important for patient's better management. Key Words: Urothelial carcinoma, sarcomatoid, divergent differentiation How to Cite: Kareem H, Jahan A, Nadeem I, Sameen S, Liaqat R, Liaquat T. Various histomorphologic patterns of urothelial carcinoma in TURBT specimen. Esculapio.2020;16(04):66-69.

High-Grade Urothelial Carcinoma on Urine Cytology Resembling Umbrella Cells

2017 ◽  
Vol 62 (1) ◽  
pp. 62-67 ◽  
Author(s):  
Andrew A. Renshaw ◽  
Edwin W. Gould
Keyword(s):  
Urothelial Carcinoma ◽  
Malignant Cell ◽  
Urine Cytology ◽  
Low Grade ◽  
High Grade ◽  
Malignant Cells ◽  
Abundant Cytoplasm ◽  
Abnormal Cells ◽  
Rare Cells ◽  
Umbrella Cells

Context: High-grade urothelial carcinoma (UC) cells have many appearances on urine cytology, but according to The Paris System, they can be easily distinguished from umbrella cells. Objective: We aimed to define the incidence and appearance of high-grade UC cells that resemble umbrella cells in Cytospin preparations on urine cytology. Results: Cytospin preparations from 331 cases with biopsy follow-up (230 benign/low-grade and 101 malignant [22 carcinoma in situ, 52 papillary, 19 invasive UC, 8 other] cases) were reviewed. A total of 18 cases with malignant cells resembling umbrella cells were identified (17.8% of the malignant cases) and were the only type of malignant cell in 3% of the cases. Two patterns were identified. Tumor cells were either identifiable by at least 20 abnormal cells which were large, had abundant cytoplasm but an elevated nuclear-to-cytoplasmic ratio, and markedly enlarged, round-to-elongated nucleoli, or else rare cells with abundant cytoplasm but obviously malignant nuclei. Cells without nucleoli or obviously malignant nuclei were not specific. Conclusions: Malignant cells resembling umbrella cells can be seen in up to 17% of urine cytology specimens.

Protonation effects on dynamic flux properties of aqueous metal complexes

2009 ◽  
Vol 74 (10) ◽  
pp. 1543-1557 ◽  
Author(s):  
Herman P. Van Leeuwen ◽  
Raewyn M. Town
Keyword(s):  
Complex Formation ◽  
Metal Ion ◽  
Good Description ◽  
Minor Component ◽  
Outer Sphere ◽  
Metal Species ◽  
Central Metal ◽  
Inner Sphere ◽  
A Minor ◽  
Protonated Ligand

The degree of (de)protonation of aqueous metal species has significant consequences for the kinetics of complex formation/dissociation. All protonated forms of both the ligand and the hydrated central metal ion contribute to the rate of complex formation to an extent weighted by the pertaining outer-sphere stabilities. Likewise, the lifetime of the uncomplexed metal is determined by all the various protonated ligand species. Therefore, the interfacial reaction layer thickness, μ, and the ensuing kinetic flux, Jkin, are more involved than in the conventional case. All inner-sphere complexes contribute to the overall rate of dissociation, as weighted by their respective rate constants for dissociation, kd. The presence of inner-sphere deprotonated H2O, or of outer-sphere protonated ligand, generally has a great impact on kd of the inner-sphere complex. Consequently, the overall flux can be dominated by a species that is a minor component of the bulk speciation. The concepts are shown to provide a good description of experimental stripping chronopotentiometric data for several protonated metal–ligand systems.

Incidentally Discovered Osseous Metaplasia Within High-grade Urothelial Carcinoma of the Bladder

Urology ◽  
2012 ◽  
Vol 79 (4) ◽  
pp. e59-e60 ◽  
Author(s):  
Anne G. Dudley ◽  
Jeffrey J. Tomaszewski ◽  
Amber H. Hughes ◽  
Benjamin J. Davies
Keyword(s):  
Urothelial Carcinoma ◽  
Osseous Metaplasia ◽  
High Grade ◽  
Carcinoma Of The Bladder

scholarly journals Expression of Semaphorin 3A in Malignant and Normal Bladder Tissue: Immunohistochemistry Staining and Morphometric Evaluation

Biology ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 109
Author(s):  
Ilan Bejar ◽  
Jacob Rubinstein ◽  
Jacob Bejar ◽  
Edmond Sabo ◽  
Hilla K Sheffer ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Carcinoma In Situ ◽  
Urothelial Cancer ◽  
Basal Layer ◽  
Low Grade ◽  
High Grade ◽  
Bladder Tissue ◽  
Normal Bladder ◽  
Normal Bladder Tissue

Introduction: Our previous studies showed elevated levels of Semaphorin3a (Sema3A) in the urine of patients with urothelial cancer compared to healthy patients. The aim of this study was to analyze the extent of Sema3A expression in normal and malignant urothelial tissue using immune-staining microscopic and morphometric analysis. Materials and Methods: Fifty-seven paraffin-embedded bladder samples were retrieved from our pathology archive and analyzed: 14 samples of normal urothelium, 21 samples containing low-grade urothelial carcinoma, 13 samples of patients with high-grade urothelial carcinoma, 7 samples containing muscle invasive urothelial carcinoma, and 2 samples with pure urothelial carcinoma in situ. All samples were immunostained with anti Sema3A antibodies. The area of tissue stained with Sema3A and its intensity were analyzed using computerized morphometry and compared between the samples’ groups. Results: In normal bladder tissue, very light Sema3A staining was demonstrated on the mucosal basal layer and completely disappeared on the apical layer. In low-grade tumor samples, cells in the basal layer of the mucosa were also lightly stained with Sema3A, but Seama3A expression intensified upon moving apically, reaching its highest level on apical cells exfoliating to the urine. In high grade urothelial tumors, Seama3A staining was intense in the entire thickness of the mucosa. In samples containing carcinoma in situ, staining intensity was high and homogenous in all the neoplastic cells. Conclusions: Sema3A may be serve as a potential non-invasive marker of urothelial cancer.

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