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A synchronous occurrence of urothelial carcinoma with abundant myxoid stroma and inverted papilloma of the urinary bladder.

Behzato─člu K, Yildiz P, Oznur M, Bozkurt ER - Rare Tumors (2012)

Bottom Line: About 90 to 100% nuclear staining was observed with p63, p53, and Ki-67.A second neoplasm with a flat overlying urothelial epithelium and a complete inverted cellular growth pattern was also noted.Considering histological, histochemical, and immunohistochemical findings, a diagnosis of synchronous urothelial carcinoma with abundant myxoid stroma and inverted papilloma was made.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Istanbul Education and Research Hospital, Ministry of Health, Istanbul;

ABSTRACT
Abundant myxoid stroma rarely occurs in urothelial carcinomas, and may cause diagnostic challenges when cells with eosinophilic cytoplasm forming nests and cords in a myxoid background are seen, particularly in the absence of typical carcinomatous appearance. Microscopic examination of transurethral resection specimen of a 71-year-old male patient revealed non-cohesive oval or elongated tumor cells with eosinophilic cytoplasm arranged in cord-like filigree pattern in an abundant myxoid stroma. Immunohistochemically the tumor was positive for cytokeratin 7, cytokeratin 20, and 34BE12. About 90 to 100% nuclear staining was observed with p63, p53, and Ki-67. A second neoplasm with a flat overlying urothelial epithelium and a complete inverted cellular growth pattern was also noted. The neoplasm exhibited less than 2% and 10% nuclear staining with Ki-67 and p53, respectively. Considering histological, histochemical, and immunohistochemical findings, a diagnosis of synchronous urothelial carcinoma with abundant myxoid stroma and inverted papilloma was made.

No MeSH data available.


Related in: MedlinePlus

The high magnification, urothelial carcinoma composed of individual cells anf irregular agregates associated with myxoid stroma.
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Figure 2: The high magnification, urothelial carcinoma composed of individual cells anf irregular agregates associated with myxoid stroma.

Mentions: In a 71-year-old male patient presenting with hematuria and dysuria, a 3-cm polypoid mass with ulceration in the right lateral wall of the urinary bladder was removed transurethrally. Microscopy showed abundant acellular faintly basophilic myxoid stroma with inter-dispensed carcinoma cells in all fields. Carcinoma comprised mostly of oval and sometimes elongated single cells with non-cohesive eosinophilic cytoplasm and occasionally their cord-like filigree patterns (Figures 1 and 2). In addition, areas of polymorph leukocyte, lymphocyte and plasmocyte infiltration mostly surrounding vascular structures were found. The surface was entirely ulcerated with no discernible epithelium. Focal areas of necrosis were observed. No glandular, sarcomatoid or micropapillary carcinomatous growth could be detected. Biopsy material consisted of only invasive carcinoma and myxoid stroma. Lamina propria and muscularis propria could not be distinguished. Within the biopsy material, a second neoplasia different from the myxoid tumor was also found with flat urothelial epithelium in the surface and complete inverted cellular growth (Figure 3). There were oval and spindle-like cells without pleomorphism but with thick cordon and trabeculae formation (Figure 4). Peripherally cellular palisade, and parallel spindle-like nuclei causing a central flow-effect were present. Cyst-like structures with eosinophilic material were also present. No mitosis was found.


A synchronous occurrence of urothelial carcinoma with abundant myxoid stroma and inverted papilloma of the urinary bladder.

Behzato─člu K, Yildiz P, Oznur M, Bozkurt ER - Rare Tumors (2012)

The high magnification, urothelial carcinoma composed of individual cells anf irregular agregates associated with myxoid stroma.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3475952&req=5

Figure 2: The high magnification, urothelial carcinoma composed of individual cells anf irregular agregates associated with myxoid stroma.
Mentions: In a 71-year-old male patient presenting with hematuria and dysuria, a 3-cm polypoid mass with ulceration in the right lateral wall of the urinary bladder was removed transurethrally. Microscopy showed abundant acellular faintly basophilic myxoid stroma with inter-dispensed carcinoma cells in all fields. Carcinoma comprised mostly of oval and sometimes elongated single cells with non-cohesive eosinophilic cytoplasm and occasionally their cord-like filigree patterns (Figures 1 and 2). In addition, areas of polymorph leukocyte, lymphocyte and plasmocyte infiltration mostly surrounding vascular structures were found. The surface was entirely ulcerated with no discernible epithelium. Focal areas of necrosis were observed. No glandular, sarcomatoid or micropapillary carcinomatous growth could be detected. Biopsy material consisted of only invasive carcinoma and myxoid stroma. Lamina propria and muscularis propria could not be distinguished. Within the biopsy material, a second neoplasia different from the myxoid tumor was also found with flat urothelial epithelium in the surface and complete inverted cellular growth (Figure 3). There were oval and spindle-like cells without pleomorphism but with thick cordon and trabeculae formation (Figure 4). Peripherally cellular palisade, and parallel spindle-like nuclei causing a central flow-effect were present. Cyst-like structures with eosinophilic material were also present. No mitosis was found.

Bottom Line: About 90 to 100% nuclear staining was observed with p63, p53, and Ki-67.A second neoplasm with a flat overlying urothelial epithelium and a complete inverted cellular growth pattern was also noted.Considering histological, histochemical, and immunohistochemical findings, a diagnosis of synchronous urothelial carcinoma with abundant myxoid stroma and inverted papilloma was made.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Istanbul Education and Research Hospital, Ministry of Health, Istanbul;

ABSTRACT
Abundant myxoid stroma rarely occurs in urothelial carcinomas, and may cause diagnostic challenges when cells with eosinophilic cytoplasm forming nests and cords in a myxoid background are seen, particularly in the absence of typical carcinomatous appearance. Microscopic examination of transurethral resection specimen of a 71-year-old male patient revealed non-cohesive oval or elongated tumor cells with eosinophilic cytoplasm arranged in cord-like filigree pattern in an abundant myxoid stroma. Immunohistochemically the tumor was positive for cytokeratin 7, cytokeratin 20, and 34BE12. About 90 to 100% nuclear staining was observed with p63, p53, and Ki-67. A second neoplasm with a flat overlying urothelial epithelium and a complete inverted cellular growth pattern was also noted. The neoplasm exhibited less than 2% and 10% nuclear staining with Ki-67 and p53, respectively. Considering histological, histochemical, and immunohistochemical findings, a diagnosis of synchronous urothelial carcinoma with abundant myxoid stroma and inverted papilloma was made.

No MeSH data available.


Related in: MedlinePlus