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Immunohistochemistry and Fluorescence In Situ Hybridization Can Inform the Differential Diagnosis of Low-Grade Noninvasive Urothelial Carcinoma with an Inverted Growth Pattern and Inverted Urothelial Papilloma.

Sun JJ, Wu Y, Lu YM, Zhang HZ, Wang T, Yang XQ, Sun MH, Wang CF - PLoS ONE (2015)

Bottom Line: Based on our analysis, Ki-67 and CK20 may be useful for the differential diagnosis of these two tumor types.Fluorescence in situ hybridization (FISH) can also provide important data in cases in which the malignant nature of an inverted urothelial neoplasm is unclear.LGNUC with an inverted growth pattern that is negative for both Ki-67 and CK20 can be positively detected using FISH.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Institute of Pathology, Fudan University, Shanghai, China.

ABSTRACT
Urothelial carcinoma (UC) comprises a heterogeneous group of epithelial neoplasms with diverse biological behaviors and variable clinical outcomes. Distinguishing UC histological subtypes has become increasingly important because prognoses and therapy can dramatically differ among subtypes. In clinical work, overlapping morphological findings between low-grade noninvasive UC (LGNUC), which exhibits an inverted growth pattern, and inverted urothelial papilloma (IUP) can make subclassification difficult. We propose a combination of immunohistochemistry (IHC) and molecular cytogenetics for subtyping these clinical entities. In our study, tissue microarray immunohistochemical profiles of Ki-67, p53, cytokeratin 20 (CK20) and cyclinD1 were assessed. Molecular genetic alterations such as the gain of chromosomes 3, 7 or 17 or the homozygous loss of 9p21 were also assessed for their usefulness in differentiating these conditions. Based on our analysis, Ki-67 and CK20 may be useful for the differential diagnosis of these two tumor types. Fluorescence in situ hybridization (FISH) can also provide important data in cases in which the malignant nature of an inverted urothelial neoplasm is unclear. LGNUC with an inverted growth pattern that is negative for both Ki-67 and CK20 can be positively detected using FISH.

No MeSH data available.


Related in: MedlinePlus

Clinicopathological features of inverted papilloma.IUPs were mainly comprised anastomosing cords, which were thin and congruous in width (A), or nests (C). Cysts were occasionally observed in the interiors of the nests (B). Peripheral palisading nuclei were observed (D).
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pone.0133530.g001: Clinicopathological features of inverted papilloma.IUPs were mainly comprised anastomosing cords, which were thin and congruous in width (A), or nests (C). Cysts were occasionally observed in the interiors of the nests (B). Peripheral palisading nuclei were observed (D).

Mentions: The morphological comparison of IUP and LGNUC with an inverted growth pattern is summarized in Table 1. All 36 inverted papillomas mainly comprised anastomosing cords, which were thin and congruous in width, or nests, which were small and regular (Fig 1). Cysts were occasionally observed in the interiors of the nests. Of the 36 inverted papillomas, peripheral palisading nuclei were observed in 31 cases (86.1%), and streaming in the inferior of cords or nests was observed in 28 cases (77.8%). Mitotic figures were seldom observed; they were only observed in the basal layer. Less than 1/10 high-power field (HPF) mitotic figures were found in all of the inverted papilloma cases in this study. The cords of LGNUC with an inverted growth pattern were usually thick and irregular, and the nests were usually large and inordinate (Fig 2). Definite fibrovascular cores were observed in 17 of 38 cases (44.7%). Mitotic figures, which were common in superficial or middle layers, were easy to detect in 20 of the 38 cases (52.6%) that exhibited >1/10 HPF in this study.


Immunohistochemistry and Fluorescence In Situ Hybridization Can Inform the Differential Diagnosis of Low-Grade Noninvasive Urothelial Carcinoma with an Inverted Growth Pattern and Inverted Urothelial Papilloma.

Sun JJ, Wu Y, Lu YM, Zhang HZ, Wang T, Yang XQ, Sun MH, Wang CF - PLoS ONE (2015)

Clinicopathological features of inverted papilloma.IUPs were mainly comprised anastomosing cords, which were thin and congruous in width (A), or nests (C). Cysts were occasionally observed in the interiors of the nests (B). Peripheral palisading nuclei were observed (D).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4514649&req=5

pone.0133530.g001: Clinicopathological features of inverted papilloma.IUPs were mainly comprised anastomosing cords, which were thin and congruous in width (A), or nests (C). Cysts were occasionally observed in the interiors of the nests (B). Peripheral palisading nuclei were observed (D).
Mentions: The morphological comparison of IUP and LGNUC with an inverted growth pattern is summarized in Table 1. All 36 inverted papillomas mainly comprised anastomosing cords, which were thin and congruous in width, or nests, which were small and regular (Fig 1). Cysts were occasionally observed in the interiors of the nests. Of the 36 inverted papillomas, peripheral palisading nuclei were observed in 31 cases (86.1%), and streaming in the inferior of cords or nests was observed in 28 cases (77.8%). Mitotic figures were seldom observed; they were only observed in the basal layer. Less than 1/10 high-power field (HPF) mitotic figures were found in all of the inverted papilloma cases in this study. The cords of LGNUC with an inverted growth pattern were usually thick and irregular, and the nests were usually large and inordinate (Fig 2). Definite fibrovascular cores were observed in 17 of 38 cases (44.7%). Mitotic figures, which were common in superficial or middle layers, were easy to detect in 20 of the 38 cases (52.6%) that exhibited >1/10 HPF in this study.

Bottom Line: Based on our analysis, Ki-67 and CK20 may be useful for the differential diagnosis of these two tumor types.Fluorescence in situ hybridization (FISH) can also provide important data in cases in which the malignant nature of an inverted urothelial neoplasm is unclear.LGNUC with an inverted growth pattern that is negative for both Ki-67 and CK20 can be positively detected using FISH.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Institute of Pathology, Fudan University, Shanghai, China.

ABSTRACT
Urothelial carcinoma (UC) comprises a heterogeneous group of epithelial neoplasms with diverse biological behaviors and variable clinical outcomes. Distinguishing UC histological subtypes has become increasingly important because prognoses and therapy can dramatically differ among subtypes. In clinical work, overlapping morphological findings between low-grade noninvasive UC (LGNUC), which exhibits an inverted growth pattern, and inverted urothelial papilloma (IUP) can make subclassification difficult. We propose a combination of immunohistochemistry (IHC) and molecular cytogenetics for subtyping these clinical entities. In our study, tissue microarray immunohistochemical profiles of Ki-67, p53, cytokeratin 20 (CK20) and cyclinD1 were assessed. Molecular genetic alterations such as the gain of chromosomes 3, 7 or 17 or the homozygous loss of 9p21 were also assessed for their usefulness in differentiating these conditions. Based on our analysis, Ki-67 and CK20 may be useful for the differential diagnosis of these two tumor types. Fluorescence in situ hybridization (FISH) can also provide important data in cases in which the malignant nature of an inverted urothelial neoplasm is unclear. LGNUC with an inverted growth pattern that is negative for both Ki-67 and CK20 can be positively detected using FISH.

No MeSH data available.


Related in: MedlinePlus