The Nested Variant of Urothelial Carcinoma: Clinicopathology of 2 Cases

2003 ◽  
Vol 127 (8) ◽  
pp. e333-e336 ◽  
Author(s):  
Guang-Qian Xiao ◽  
Stephen J. Savage ◽  
Michael E. Gribetz ◽  
David E. Burstein ◽  
Lorraine K. Miller ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Tumor Cells ◽  
Immunohistochemical Staining ◽  
Bladder Tumor ◽  
Low Grade ◽  
Elderly Men ◽  
Ki 67 ◽  
Tumor Entity ◽  
Nested Variant ◽  
Nuclear Features

Abstract The nested variant of urothelial carcinoma is a recently described bladder tumor entity with a rare incidence. Two cases of this disease are presented in this report; the patients in both cases were elderly men, with a predominant involvement of the trigone region. Histologically, the tumor cells were arranged in ill-defined nests and had low-grade nuclear features. Both cases had a diffusely infiltrating growth pattern with widespread local disease at cystectomy. Strong immunohistochemical staining for p63 in the neoplastic cells supports the urothelial cell nature of this neoplasm. High p53 and Ki-67 indices of this tumor correlate with the aggressiveness of this subtype.

scholarly journals Nested variant of urothelial carcinoma of the urinary bladder

Rare Tumors ◽  
2011 ◽  
Vol 3 (4) ◽  
pp. 132-134 ◽  
Author(s):  
Tadashi Terada
Keyword(s):  
Urothelial Carcinoma ◽  
Lamina Propria ◽  
Bladder Tumor ◽  
Clinical Course ◽  
Carcinoma Cells ◽  
Ki 67 ◽  
Atypical Cells ◽  
Nested Variant ◽  
Aggressive Clinical Course ◽  
Nephrogenic Metaplasia

The nested variant of urothelial carcinoma (NVUC) is characterized by the presence of benign-appearing urothelial carcinoma cells in the lamina propria, sparing the surface urothelial involvement. NVUC shows aggressive clinical course despite of benign-looking histology. Herein reported are two cases of NVUC. One is 80-year-old woman, and another is 78-year-old man. In both cases, atypical cells forming nests and tubules were seen in the lamina propria without surface urothelial involvement. One case resembled nephrogenic metaplasia and another proliferated Brunn's nest or inverted papilloma. Immunohistochemically, both cases showed positive p53 and high Ki67 labeling, suggesting that both cases are malignant. Immunohistochemically, one case was characterized by positive cytokeratins, EMA, p53, Ki-67 (labeling=15%), α-methylacyl CoA racemase, CA19-9, and MUC1, and another case by positive cytokeratins, EMA, p63, p53, Ki-67 (lebeling=30%), CD10, CEA, and MUC1. Cyto keratin immunoprofiles were described and other antigens’ expressions were shown. The patients are now free of tumor 6 and 15 months after the resection of the bladder tumor.

scholarly journals A Rare Primary Tumor of the Thyroid Gland: A New Case of Leiomyoma and Literature Review

2018 ◽  
Vol 12 ◽  
pp. 117955491881353
Author(s):  
Yanling Zhang ◽  
Heng Tang ◽  
Huaiyuan Hu ◽  
Xiang Yong
Keyword(s):  
Thyroid Gland ◽  
Tumor Cells ◽  
Immunohistochemical Staining ◽  
Smooth Muscle Actin ◽  
Frozen Sections ◽  
Ki 67 ◽  
Eosinophilic Cytoplasm ◽  
S 100 ◽  
Painless Mass ◽  
The Right

Primary leiomyomas of the thyroid are very rare. We here report a case of a 53-year-old woman with a painless mass at the right thyroid, revealed by physical examination. The patient underwent a lobectomy. Frozen sections showed a spindle cell tumor of the thyroid gland. The nuclei of some of the tumor cells were obviously enlarged and deeply stained. Pseudocapsule invasion was observed in small foci. Samples showed neither mitosis nor necrosis and the nature of the tumor was difficult to determine. Paraffin sections showed a well-circumscribed nodular composed of intersecting fascicles of spindled to slightly epithelioid cells with eosinophilic cytoplasm and blunt-ended, cigar-shaped nuclei. We observed no significant nuclear atypia, mitotsis, or necrosis. Immunohistochemical staining showed the tumor cells to be positive for α-smooth muscle actin and h-caldesmon but negative for TG, TTF1, PAX8, S-100, CT, CK, and CD34. The ki-67 index was very low (<1%). Primary thyroid leiomyoma is rare and difficult to diagnose using frozen sections. Diagnosis requires immunohistochemical staining. Leiomyoma may be mistaken for other thyroid tumors also characterized by spindle cells.

Umbrella Cells Mimicking Focal High-Grade Urothelial Carcinoma in Low-Grade Papillary Urothelial Carcinoma

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S121-S121
Author(s):  
Muhammad Masood Hassan ◽  
Tammey Naab ◽  
Ali Afsari
Keyword(s):  
Urothelial Carcinoma ◽  
Proliferation Index ◽  
Low Grade ◽  
High Grade ◽  
Ki 67 ◽  
Prostate Hyperplasia ◽  
History Of ◽  
Papillary Urothelial Carcinoma ◽  
Artery Disease ◽  
Umbrella Cells

Abstract Objectives Low-grade papillary urothelial carcinoma (LGUC) has overall a preserved orderly appearance, minimal variability in architecture, and lack of significant cytologic atypia and mitotic activity without pleomorphism. A total of 53.8% of LGUC cases recur with 18.3% progression to high-grade UC. Even focal HGUC in LGUC can be a harbinger of progression. Accurate pathological interpretation is paramount in predicting recurrence and determining treatment. Methods A 63-year-old male with a past medical history of coronary artery disease, benign prostate hyperplasia, and obesity was referred to urology with a chief complaint of chronic hematuria. Cystoscopy with transurethral resection of bladder tumor was performed, which revealed mainly LGUC with focal high-grade-appearing UC. Results Histologic sections revealed papillary architecture with fused fronds, low-grade nuclear atypia, and scattered mitoses comprising 95% of the tissue submitted. No muscular wall invasion by carcinoma was seen. However, in one section, collections of large cells with well-defined cytoplasmic borders, multinucleation, and rare nuclear grooves were identified. The morphology raised the suspicion of a focal HGUC. Diffuse expression of CK20 and low Ki-67 proliferation index (1%) favored umbrella cells. Conclusion Our case reinforces the fact that sectioning can reveal foci, suspicious for HGUC, especially in urothelium. However, proper interpretation of morphology combined with the help of immunohistochemistry aids in accurate diagnosis, which is critical in determining proper clinical management of the patient.

scholarly journals Primary sinonasal renal cell-like adenocarcinoma: a case report and review of the literature

2020 ◽  
Author(s):  
Xiaoxia Gou ◽  
Yanzhe Wang ◽  
Fang Chen ◽  
Xiaoli Liu ◽  
Peigang Ruan ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Renal Cell ◽  
Low Grade ◽  
Cell Renal Cell Carcinoma ◽  
Ki 67 ◽  
Pathological Characteristics ◽  
S 100 ◽  
Clear Cytoplasm ◽  
The Right ◽  
Irregular Mass

Abstract BackgroundPrimary sinonasal renal cell-like adenocarcinoma (SNRCLA) is an extremely rare neoplasm with unique clinical and pathological features. At present, there is no summary of its clinical and pathological characteristics. We treated one case and reported to here. Review the domestic and foreign literature, summarize its clinical pathological characteristics and diagnosis and treatment.CaseA 69-year-old female presented with repeated epistaxis, nasal obstruction of 2-years’ duration. Computed tomography (CT) was performed revealing an irregular mass of the right nasal cavity involving choana and nasopharynx. The patient was treated with endonasal endoscopic resection. Histologically, SNRCLA was very similar to clear cell renal cell carcinoma (RCC), the tumor cells were round or polygonal in size with abundant clear cytoplasm and uniform nuclei. The tumor cells positive for CK7, Vimentin, EMA, S-100, Ki-67 (5% +) and negative for CEA, P53, P63 by immunohistochemical staining,. The patient is free from recurrence over 27 months after the surgery.ConclusionSNRCLA seems to be a low-grade localized carcinoma associated with favorable prognosis. Surgical resection is recommended as the main stay of treatment.

Clinicopathological study of urothelial neoplasms in urinary bladder with special reference to expression of Her2/neu and Ki-67 in malignant lesions

2021 ◽  
Vol 8 (3) ◽  
pp. 378-385
Author(s):  
Sarmila Sen ◽  
Ayesha Abid ◽  
Ranjana Bandyopadhyay
Keyword(s):  
Urothelial Carcinoma ◽  
Histological Grade ◽  
Tertiary Care ◽  
Population Group ◽  
Low Grade ◽  
Care Hospital ◽  
Ki 67 ◽  
Cross Sectional ◽  
Non Invasive ◽  
Urothelial Carcinomas

Urothelial carcinomas are the fourth most common tumors worldwide. Studies have shown that Her2/neu is associated with increased tumour grade and Ki‐67 is related to tumour recurrence and stage progression. As no such study has been undertaken is this region, the present study was aimed to establish Her2/neu and Ki-67 as novel prognostic markers of urothelial neoplasms.: To evaluate the clinical profile of urothelial neoplasms and correlate the expression of Her2/neu and Ki-67 in urothelial carcinomas.Observational and cross-sectional study (January 2018-May 2019) in a tertiary care hospital in Eastern India.: 40 specimens of urothelial neoplasms were studied. Clinical history of patients was collected. Microscopic examination was done to assess tumour stage and histological grade. Immunohistochemistry with Her2/neu and Ki-67 was performed.: Statistical Package for the Social Sciences SPSS (version 20.0, IBM, Chicago, IL, USA) for windows software.: 8 cases were diagnosed as low grade non-invasive urothelial carcinoma, 31 cases as infiltrating urothelial carcinoma and 1 case as papillary urothelial neoplasm of low malignant potential (PUNLMP). 96.8% of infiltrating carcinomas and 87.5% of low grade non-invasive carcinomas showed Ki-67 positivity. Moderate-to-strong Her2/neu overexpression (2+ or 3+) was observed in only 21% of the cases.: The expression of Ki-67 increased with increase in the grade of the tumour which was suggestive of the prognostic importance of Ki-67. Her2/neu positivity was seen in infiltrating cases. No significant association between the tumor grade and Her2/neu expression, indicated the need for further studies with a larger population group.

scholarly journals Epithelium Lining Rat Renal Papilla: Nomenclature and Association with Chronic Progressive Nephropathy (CPN)

2018 ◽  
Vol 46 (3) ◽  
pp. 266-272 ◽  
Author(s):  
Nathália P. Souza ◽  
Gordon C. Hard ◽  
Lora L. Arnold ◽  
Kirk W. Foster ◽  
Karen L. Pennington ◽  
...  
Keyword(s):  
Immunohistochemical Staining ◽  
Low Grade ◽  
High Grade ◽  
Aged Rats ◽  
Renal Papilla ◽  
Diagnostic Systems ◽  
Ki 67 ◽  
Kidney Pelvis ◽  
Specific Proteins ◽  
Mitotic Figures

Chronic progressive nephropathy (CPN) occurs commonly in rats, more frequently and severely in males than females. High-grade CPN is characterized by increased layers of the renal papilla lining, designated as urothelial hyperplasia in the International Harmonization of Nomenclature and Diagnostic Criteria classification. However, urothelium lining the pelvis is not equivalent to the epithelium lining the papilla. To evaluate whether the epithelium lining the renal papilla is actually urothelial in nature and whether CPN-associated multicellularity represents proliferation, kidney tissues from aged rats with CPN, from rats with multicellularity of the renal papilla epithelium of either low-grade or marked severity, and from young rats with normal kidneys were analyzed and compared. Immunohistochemical staining for uroplakins (urothelial specific proteins) was negative in the papilla epithelium in all rats with multicellularity or not, indicating these cells are not urothelial. Mitotic figures were rarely observed in this epithelium, even with multicellularity. Immunohistochemical staining for Ki-67 was negative. Papilla lining cells and true urothelium differed by scanning electron microscopy. Based on these findings, we recommend that the epithelium lining the papilla not be classified as urothelial, and the CPN-associated lesion be designated as vesicular alteration of renal papilla instead of hyperplasia and distinguished in diagnostic systems from kidney pelvis urothelial hyperplasia.

scholarly journals Computer-assisted quantitative analysis of Ki-67 antigen in dysplasia: Associated lesions or masses in ulcerative colitis

2007 ◽  
Vol 64 (11) ◽  
pp. 753-758
Author(s):  
Vesna Zivkovic ◽  
Aleksandar Petrovic ◽  
Biljana Djordjevic ◽  
Vuka Katic ◽  
Jasmina Gligorijevic ◽  
...  
Keyword(s):  
Immunohistochemical Staining ◽  
Staining Intensity ◽  
High Grade Dysplasia ◽  
Computer Assisted ◽  
Low Grade ◽  
High Grade ◽  
Ki 67 ◽  
Associated Lesions ◽  
Low Grade Dysplasia ◽  
The Difference

Background/Aim. The aim of this study was to apply computer- assisted methodology in assessment of Ki-67 positivity in "adenoma-like" dysplasia associated lesions or masses (DALMs), and carcinoma in ulcerative colitis (UC), and to determine a new approach to grading of Ki-67 staining intensity. Methods. Immunohistochemical slides were quantitatively analyzed for estimation of proportion and intensity of Ki-67 positive-stained cells in a total of 50 "adenoma-like" DALMs (27 with low-grade dysplasia and 23 with high-grade dysplasia), and 17 adenocarcinomas associated with UC. The four grades of immunohistochemical staining intensity were established by an automated classification of nuclear optical densities. Results. The Ki-67 labeling index (LI) in low-grade dysplasia was significantly lower than in high-grade dysplasia, and carcinoma (p < 0.001). The Ki-67 LI of carcinomas was not significantly different from the value obtained in highgrade dysplasia (p > 0.05), however having the difference in percentage values of the moderate stained nuclei (p < 0.05). The overall average values of chromogene nuclear optical density, showed statistically significant differences between DALMs and carcinoma (p < 0.05), although not between normal mucosa and low-grade dysplasia (p > 0.05). Conclusion. The obtained results imply, according to the overall percentage of labeled nuclei, that high-grade dysplasia is very close to carcinoma, while there is the difference in the percentage of moderately stained nuclei. We showed that Ki-67 positivity have a different internal distribution which could be useful in analysing these lesions. These findings also, indicate the important biological differences between low-grade dysplasia and carcinoma in UC, and a low proliferative potential of the former. Automated image analysis permits an objective estimation of Ki-67 immunohistochemical staining in UCassociated dysplasia and carcinoma.

scholarly journals Case Report: Large nested variant urothelial carcinoma –invasive malignancy masquerading as low grade disease

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 314
Author(s):  
Andrew Keller ◽  
Ai Jye Lim ◽  
Ahmad Ali
Keyword(s):  
Case Report ◽  
Urothelial Carcinoma ◽  
Urothelial Cancer ◽  
Muscularis Propria ◽  
Low Grade ◽  
Clinical Recurrence ◽  
Non Invasive ◽  
Operative Specimen ◽  
Cytological Features ◽  
Nested Variant

IntroductionThe large nested variant of urothelial carcinoma (LNVUC) is a newly described and rare subtype of urothelial carcinoma. It is characterised by bland cytological features and a large nested architecture similar in appearance to low grade urothelial carcinoma with an inverted growth pattern. To date only 23 cases in a single series have been described.Case ReportWe describe the case of a 59 year old male with LNVUC whose tumour was initially misdiagnosed as a non-invasive low grade urothelial carcinoma. At a subsequent re-resection, his tumour was correctly re-classified as LNVUC with extensive invasion of the muscularis propria. Radical cystectomy and formation of an ileal conduit was performed. His operative specimen revealed invasion of prostatic stroma and perivesical fat, with all surgical margins clear. He is currently free from clinical recurrence 12 months after his cystectomy.ConclusionLNVUC is a newly described and rare urothelial carcinoma subtype. It characteristically possesses bland cytological features and may mimic low grade urothelial cancer. Despite its bland appearance it behaves aggressively with invasion, metastasis and death being common.

scholarly journals Cytoplasmic expression of C-MYC protein is associated with risk stratification of mantle cell lymphoma

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3457 ◽  
Author(s):  
Yi Gong ◽  
Xi Zhang ◽  
Rui Chen ◽  
Yan Wei ◽  
Zhongmin Zou ◽  
...  
Keyword(s):  
T Lymphocytes ◽  
Risk Stratification ◽  
Tumor Cells ◽  
Immunohistochemical Staining ◽  
Cell Lymphoma ◽  
Rank Correlation ◽  
Ki 67 ◽  
Spearman’S Rank Correlation ◽  
Spearman’S Rank Correlation Coefficient ◽  
Mantle Cell

AimTo investigate the association of C-MYC protein expression and risk stratification in mantle cell lymphoma (MCL), and to evaluate the utility of C-MYC protein as a prognostic biomarker in clinical practice.MethodsWe conducted immunohistochemical staining of C-MYC, Programmed cell death ligand 1 (PD-L1), CD8, Ki-67, p53 and SRY (sex determining region Y) -11 (SOX11) to investigate their expression in 64 patients with MCL. The staining results and other clinical data were evaluated for their roles in risk stratification of MCL cases using ANOVA, Chi-square, and Spearman’s Rank correlation coefficient analysis.ResultsImmunohistochemical staining in our study indicated that SOX11, Ki-67 and p53 presented nuclear positivity of tumor cells, CD8 showed membrane positivity in infiltrating T lymphocytes while PD-L1 showed membrane and cytoplasmic positivity mainly in macrophage cells and little in tumor cells. We observed positive staining of C-MYC either in the nucleus or cytoplasm or in both subcellular locations. There were significant differences in cytoplasmic C-MYC expression, Ki-67 proliferative index of tumor cells, and CD8 positive tumor infiltrating lymphocytes (CD8+TIL) among three risk groups (P = 0.000,P = 0.037 andP=0.020, respectively). However, no significant differences existed in the expression of nuclear C-MYC, SOX11, p53, and PD-L1 in MCL patients with low-, intermediate-, and high risks. In addition, patient age and serum LDH level were also significantly different among 3 groups of patients (P = 0.006 andP = 0.000, respectively). Spearman’s rank correlation coefficient analysis indicated that cytoplasmic C-MYC expression, Ki-67 index, age, WBC, as well as LDH level had significantly positive correlations with risk stratification (P = 0.000, 0.015, 0.000, 0.029 and 0.000, respectively), while CD8+TIL in tumor microenvironment negatively correlated with risk stratification of patients (P = 0.006). Patients with increased positive cytoplasmic expression of C-MYC protein and decreased CD8+TIL appeared to be associated with a poor response to chemotherapy, but the correlation was not statistically significant.ConclusionOur study suggested that assessment of cytoplasmic C-MYC overexpression and cytotoxic T lymphocytes (CTLs) by immunohistochemical staining might be helpful for MCL risk stratification and outcome prediction. However, large cohort studies of MCL patients with complete follow up are needed to validate our speculation.

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