Authors: Shanks, J H; Iczkowski, K A

Source: Histopathology, Volume 54, Number 7, June 2009 , pp. 885-900(16)

Publisher: Wiley-Blackwell

Abstract:

Shanks J H & Iczkowski K A

(2009) Histopathology 54, 885-900

Divergent differentiation in urothelial carcinoma and other bladder cancer subtypes with selected mimics

Conventional urothelial carcinoma accounts for most carcinomas of the urinary tract lining. However, neoplastic urothelium has the capacity to demonstrate enormous plasticity. A variety of unusual architectural patterns of urothelial carcinoma, such as the nested, microcystic and inverted variants, can be mistaken for reactive processes or benign tumours. Others such as the micropapillary, plasmacytoid and discohesive variants, can mimic metastatic tumour from other sites. The micropapillary variant in particular is more aggressive. In addition, urothelial carcinoma has a propensity to demonstrate divergent differentiation with glandular, squamous, small cell neuroendocrine, lymphoepithelioma-like, sarcomatoid or other elements. Pure squamous carcinoma or adenocarcinoma (the latter in particular) can be difficult to distinguish from contiguous or metastatic spread. Some variants have prognostic and potential therapeutic implications. Molecular genetic evidence has emerged recently supporting a close relationship between urothelial carcinoma and various divergent elements. Sarcomatoid carcinoma and its differential diagnosis with other spindle cell lesions of urinary tract will be covered in a separate review.

Keywords: adenocarcinoma; bladder; bladder cancer; glandular; inverted; lipoid; lymphoepithelioma-like; microcystic; micropapillary; nephrogenic adenoma; nested; plasmacytoid; small cell carcinoma; squamous; trophoblastic; urothelial; variants

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2559.2008.03167.x

Affiliations: 1: Department of Pathology, University of Colorado Health Science Center, Aurora, CO, USA

Publication date: 2009-06-01

Related content

• In this: publication
• By this: publisher
• In this Subject: Pathology
• By this author: Shanks, J H ;  Iczkowski, K A

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers