Urothelial carcinoma - Revision history

Michael at 12:54, 13 June 2024

2024-06-13T12:54:10Z

← Older revision		Revision as of 12:54, 13 June 2024
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	\| IF =		\| IF =
	\| Gross =		\| Gross =
	\| Grossing = [[radical cystectomy grossing]], [[cystoprostatectomy grossing]], [[nephroureterectomy grossing]]		\| Grossing = [[transurethral resection of bladder tumour grossing]], [[radical cystectomy grossing]], [[cystoprostatectomy grossing]], [[nephroureterectomy grossing]]
	\| Staging = [[bladder cancer staging]]		\| Staging = [[bladder cancer staging]]
	\| Site = [[urothelium]] - [[ureter]], [[urinary bladder]], proximal [[urethra]] (see [[urothelial carcinoma of the urethra]], renal pelvis		\| Site = [[urothelium]] - [[ureter]], [[urinary bladder]], proximal [[urethra]] (see [[urothelial carcinoma of the urethra]], renal pelvis

Michael at 16:10, 8 March 2024

2024-03-08T16:10:19Z

← Older revision		Revision as of 16:10, 8 March 2024
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	\| IHC = [[GATA3]] +ve, p63 +ve, CK5/6 +ve, CK34betaE12 +ve, PSA -ve		\| IHC = [[GATA3]] +ve, p63 +ve, CK5/6 +ve, CK34betaE12 +ve, PSA -ve
	\| EM =		\| EM =
	\| Molecular = not used for diagnosis; typically: 9p deletions, 17p deletions		\| Molecular = not used for diagnosis; typically: 9p deletions, 17p deletions; can be [[Classification of urothelial carcinoma by immunohistochemistry\|subclassified with IHC]]; [[FGFR2/FGFR3]] mutations
	\| IF =		\| IF =
	\| Gross =		\| Gross =

Michael: /* Molecular */

2021-10-26T17:22:23Z

Molecular

← Older revision		Revision as of 17:22, 26 October 2021
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	=Molecular=		=Molecular=
	*~~Usually~~ ''not'' used for diagnosis.		*Molecular testing usually ''not'' used for diagnosis.
			**Molecular subtyping can be approximated with immunostaining - see ''[[Classification of urothelial carcinoma by immunohistochemistry]]''.

	Changes:		Changes:
	*9p deletion -- site of CDKN2A<ref name=omim600160>{{OMIM\|600160}}</ref> (AKA p16).		*9p deletion -- site of CDKN2A<ref name=omim600160>{{OMIM\|600160}}</ref> (AKA p16).
	*17p deletion -- site of PT53 (AKA p53).		*17p deletion -- site of PT53 (AKA p53).

	~~Molecular subtyping can be approximated with immunostaining - see ''[[Classification of urothelial carcinoma by immunohistochemistry]]''.~~

	=Sign out=		=Sign out=

Michael: /* Molecular */

2021-10-26T17:21:59Z

Molecular

← Older revision		Revision as of 17:21, 26 October 2021
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	=Molecular=		=Molecular=
	~~Not~~ used for diagnosis.		*Usually ''not'' used for diagnosis.

	Changes:		Changes:
	*9p deletion -- site of CDKN2A<ref name=omim600160>{{OMIM\|600160}}</ref> (AKA p16).		*9p deletion -- site of CDKN2A<ref name=omim600160>{{OMIM\|600160}}</ref> (AKA p16).
	*17p deletion -- site of PT53 (AKA p53).		*17p deletion -- site of PT53 (AKA p53).

			Molecular subtyping can be approximated with immunostaining - see ''[[Classification of urothelial carcinoma by immunohistochemistry]]''.

	=Sign out=		=Sign out=

Michael: /* Microscopic */

2021-10-13T14:47:10Z

Microscopic

← Older revision		Revision as of 14:47, 13 October 2021
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	*[[Low-grade papillary urothelial carcinoma]].		*[[Low-grade papillary urothelial carcinoma]].
	*[[Prostate carcinoma]] - may have pseudopapillae<ref name=pmid24503758>{{cite journal \|author=Gordetsky J, Epstein JI \|title=Pseudopapillary features in prostatic adenocarcinoma mimicking urothelial carcinoma: a diagnostic pitfall \|journal=Am. J. Surg. Pathol. \|volume=38 \|issue=7 \|pages=941–5 \|year=2014 \|month=July \|pmid=24503758 \|doi=10.1097/PAS.0000000000000178 \|url=}}</ref> - see ''[[urothelial carcinoma-like prostatic carcinoma]]''.		*[[Prostate carcinoma]] - may have pseudopapillae<ref name=pmid24503758>{{cite journal \|author=Gordetsky J, Epstein JI \|title=Pseudopapillary features in prostatic adenocarcinoma mimicking urothelial carcinoma: a diagnostic pitfall \|journal=Am. J. Surg. Pathol. \|volume=38 \|issue=7 \|pages=941–5 \|year=2014 \|month=July \|pmid=24503758 \|doi=10.1097/PAS.0000000000000178 \|url=}}</ref> - see ''[[urothelial carcinoma-like prostatic carcinoma]]''.
	*[[Epithelioid angiosarcoma]] - have ~~pseudovascular spaces~~, usually a history radiation treatment.<ref name=pmid25929352>{{cite journal \|authors=Matoso A, Epstein JI \|title=Epithelioid Angiosarcoma of the Bladder: A Series of 9 Cases \|journal=Am J Surg Pathol \|volume=39 \|issue=10 \|pages=1377–82 \|date=October 2015 \|pmid=25929352 \|doi=10.1097/PAS.0000000000000444 \|url=}}</ref>		*[[Epithelioid angiosarcoma]] - have intracytoplasmic lumens and interspersed red blood cells, usually have a history radiation treatment.<ref name=pmid25929352>{{cite journal \|authors=Matoso A, Epstein JI \|title=Epithelioid Angiosarcoma of the Bladder: A Series of 9 Cases \|journal=Am J Surg Pathol \|volume=39 \|issue=10 \|pages=1377–82 \|date=October 2015 \|pmid=25929352 \|doi=10.1097/PAS.0000000000000444 \|url=}}</ref>

	==Staging==		==Staging==

Michael: fix vauthors

2021-10-13T14:45:43Z

fix vauthors

← Older revision		Revision as of 14:45, 13 October 2021
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	*[[Low-grade papillary urothelial carcinoma]].		*[[Low-grade papillary urothelial carcinoma]].
	*[[Prostate carcinoma]] - may have pseudopapillae<ref name=pmid24503758>{{cite journal \|author=Gordetsky J, Epstein JI \|title=Pseudopapillary features in prostatic adenocarcinoma mimicking urothelial carcinoma: a diagnostic pitfall \|journal=Am. J. Surg. Pathol. \|volume=38 \|issue=7 \|pages=941–5 \|year=2014 \|month=July \|pmid=24503758 \|doi=10.1097/PAS.0000000000000178 \|url=}}</ref> - see ''[[urothelial carcinoma-like prostatic carcinoma]]''.		*[[Prostate carcinoma]] - may have pseudopapillae<ref name=pmid24503758>{{cite journal \|author=Gordetsky J, Epstein JI \|title=Pseudopapillary features in prostatic adenocarcinoma mimicking urothelial carcinoma: a diagnostic pitfall \|journal=Am. J. Surg. Pathol. \|volume=38 \|issue=7 \|pages=941–5 \|year=2014 \|month=July \|pmid=24503758 \|doi=10.1097/PAS.0000000000000178 \|url=}}</ref> - see ''[[urothelial carcinoma-like prostatic carcinoma]]''.
	*[[Epithelioid angiosarcoma]] - have pseudovascular spaces, usually a history radiation treatment.<ref name=pmid25929352>{{cite journal \|~~vauthors~~=Matoso A, Epstein JI \|title=Epithelioid Angiosarcoma of the Bladder: A Series of 9 Cases \|journal=Am J Surg Pathol \|volume=39 \|issue=10 \|pages=1377–82 \|date=October 2015 \|pmid=25929352 \|doi=10.1097/PAS.0000000000000444 \|url=}}</ref>		*[[Epithelioid angiosarcoma]] - have pseudovascular spaces, usually a history radiation treatment.<ref name=pmid25929352>{{cite journal \|authors=Matoso A, Epstein JI \|title=Epithelioid Angiosarcoma of the Bladder: A Series of 9 Cases \|journal=Am J Surg Pathol \|volume=39 \|issue=10 \|pages=1377–82 \|date=October 2015 \|pmid=25929352 \|doi=10.1097/PAS.0000000000000444 \|url=}}</ref>

	==Staging==		==Staging==

Michael: +angiosarc

2021-10-13T14:40:37Z

+angiosarc

← Older revision		Revision as of 14:40, 13 October 2021
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	\| Micro =		\| Micro =
	\| Subtypes = [[microcystic urothelial carcinoma\|microcystic]], [[micropapillary urothelial carcinoma\|micropapillary]], glandular, inverted (growth pattern), [[nested urothelial carcinoma\|nested]], papillary (dealt with separately in ''[[high-grade papillary urothelial carcinoma]]'' and ''[[low-grade papillary urothelial carcinoma]]''), [[plasmacytoid urothelial carcinoma]], others		\| Subtypes = [[microcystic urothelial carcinoma\|microcystic]], [[micropapillary urothelial carcinoma\|micropapillary]], glandular, inverted (growth pattern), [[nested urothelial carcinoma\|nested]], papillary (dealt with separately in ''[[high-grade papillary urothelial carcinoma]]'' and ''[[low-grade papillary urothelial carcinoma]]''), [[plasmacytoid urothelial carcinoma]], others
	\| LMDDx = [[urothelial carcinoma in situ]], metastatic carcinoma ([[prostate carcinoma]], [[colorectal carcinoma]]), [[inverted urothelial papilloma]] (for UCC with inverted growth pattern)		\| LMDDx = [[urothelial carcinoma in situ]], metastatic carcinoma ([[prostate carcinoma]], [[colorectal carcinoma]]), [[inverted urothelial papilloma]] (for UCC with inverted growth pattern), [[epithelioid angiosarcoma]]
	\| Stains =		\| Stains =
	\| IHC = [[GATA3]] +ve, p63 +ve, CK5/6 +ve, CK34betaE12 +ve, PSA -ve		\| IHC = [[GATA3]] +ve, p63 +ve, CK5/6 +ve, CK34betaE12 +ve, PSA -ve
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	*[[Low-grade papillary urothelial carcinoma]].		*[[Low-grade papillary urothelial carcinoma]].
	*[[Prostate carcinoma]] - may have pseudopapillae<ref name=pmid24503758>{{cite journal \|author=Gordetsky J, Epstein JI \|title=Pseudopapillary features in prostatic adenocarcinoma mimicking urothelial carcinoma: a diagnostic pitfall \|journal=Am. J. Surg. Pathol. \|volume=38 \|issue=7 \|pages=941–5 \|year=2014 \|month=July \|pmid=24503758 \|doi=10.1097/PAS.0000000000000178 \|url=}}</ref> - see ''[[urothelial carcinoma-like prostatic carcinoma]]''.		*[[Prostate carcinoma]] - may have pseudopapillae<ref name=pmid24503758>{{cite journal \|author=Gordetsky J, Epstein JI \|title=Pseudopapillary features in prostatic adenocarcinoma mimicking urothelial carcinoma: a diagnostic pitfall \|journal=Am. J. Surg. Pathol. \|volume=38 \|issue=7 \|pages=941–5 \|year=2014 \|month=July \|pmid=24503758 \|doi=10.1097/PAS.0000000000000178 \|url=}}</ref> - see ''[[urothelial carcinoma-like prostatic carcinoma]]''.
			*[[Epithelioid angiosarcoma]] - have pseudovascular spaces, usually a history radiation treatment.<ref name=pmid25929352>{{cite journal \|vauthors=Matoso A, Epstein JI \|title=Epithelioid Angiosarcoma of the Bladder: A Series of 9 Cases \|journal=Am J Surg Pathol \|volume=39 \|issue=10 \|pages=1377–82 \|date=October 2015 \|pmid=25929352 \|doi=10.1097/PAS.0000000000000444 \|url=}}</ref>

	==Staging==		==Staging==

Mitchell: /* Images */ add a case

2017-02-03T20:44:32Z

Images: add a case

← Older revision		Revision as of 20:44, 3 February 2017
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	www:		www:
	*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282447/figure/F2/ Several images of NUCC (nih.gov)].<ref name=pmid22355497>{{Cite journal \| last1 = Terada \| first1 = T. \| title = Nested variant of urothelial carcinoma of the urinary bladder. \| journal = Rare Tumors \| volume = 3 \| issue = 4 \| pages = e42 \| month = Oct \| year = 2011 \| doi = 10.4081/rt.2011.e42 \| PMID = 22355497 \| PMC = 3282447 }}</ref>		*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282447/figure/F2/ Several images of NUCC (nih.gov)].<ref name=pmid22355497>{{Cite journal \| last1 = Terada \| first1 = T. \| title = Nested variant of urothelial carcinoma of the urinary bladder. \| journal = Rare Tumors \| volume = 3 \| issue = 4 \| pages = e42 \| month = Oct \| year = 2011 \| doi = 10.4081/rt.2011.e42 \| PMID = 22355497 \| PMC = 3282447 }}</ref>

			[[File:5 410253052 sl 1.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 2.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 3.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 4.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 5.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 6.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 7.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 8.png\| High grade urothelial carcinoma]]<br>
			High grade urothelial carcinoma in a 43 year old man. A. At low power, necrosis is seen, luminal, with viable invasive tumor elsewhere. B. Tumor partly fills right ureteral orifice. C. Tumor cells sometimes form Indian files (black arrows), appear to have nuclei that mold (red arrows), and have granular chromatin (cyan arrows), raising possibility of neuroendocrine carcinoma. D. Tumor invades lymphatic spaces. E. Urothelial carcinoma in situ is present. F,G,H. Tumor cells are diffusely positive for CK7, focally positive for CDX2, and diffusely positive for P40, with no positivity for chromogranin or synaptophysin.

	=[[IHC]]=		=[[IHC]]=

Michael: /* IHC for staging */

2017-01-27T15:37:57Z

IHC for staging

← Older revision		Revision as of 15:37, 27 January 2017
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	===IHC for staging===		===IHC for staging===
	~~Staging -~~ [[bladder muscularis propria invasion\|muscularis propria invasion]] versus muscularis mucosae invasion ''~~smoothelin~~'' stain:<ref>{{Cite journal \| last1 = Paner \| first1 = GP. \| last2 = Shen \| first2 = SS. \| last3 = Lapetino \| first3 = S. \| last4 = Venkataraman \| first4 = G. \| last5 = Barkan \| first5 = GA. \| last6 = Quek \| first6 = ML. \| last7 = Ro \| first7 = JY. \| last8 = Amin \| first8 = MB. \| title = Diagnostic utility of antibody to smoothelin in the distinction of muscularis propria from muscularis mucosae of the urinary bladder: a potential ancillary tool in the pathologic staging of invasive urothelial carcinoma. \| journal = Am J Surg Pathol \| volume = 33 \| issue = 1 \| pages = 91-8 \| month = Jan \| year = 2009 \| doi = 10.1097/PAS.0b013e3181804727 \| PMID = 18936687 }}</ref>		*''Smoothelin'' immunostain for [[bladder muscularis propria invasion\|muscularis propria invasion]] versus muscularis mucosae invasion - see ''[[Muscularis_propria_invasion_in_the_urinary_bladder#IHC]]''.
	*Muscularis propria - usu. strong. †
	*Muscularis mucosae - negative/weak. †

	~~Note:~~
	*† Overlap between the patterns is described,<ref>{{Cite journal \| last1 = Miyamoto \| first1 = H. \| last2 = Sharma \| first2 = RB. \| last3 = Illei \| first3 = PB. \| last4 = Epstein \| first4 = JI. \| title = Pitfalls in the use of smoothelin to identify muscularis propria invasion by urothelial carcinoma. \| journal = Am J Surg Pathol \| volume = 34 \| issue = 3 \| pages = 418-22 \| month = Mar \| year = 2010 \| doi = 10.1097/PAS.0b013e3181ce5066 \| PMID = 20154589 }}</ref> this limits the utility of the stain.

	=Molecular=		=Molecular=

Michael: /* UCC versus other */

2017-01-23T18:33:39Z

UCC versus other

← Older revision		Revision as of 18:33, 23 January 2017
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	:''See [[urothelial carcinoma in situ]]''.		:''See [[urothelial carcinoma in situ]]''.

	===UCC versus other===		===UCC versus other cancers===
	UCC vs. [[Prostate cancer\|prostate]]:		UCC vs. [[Prostate cancer\|prostate]]:
	*UCC: GATA3 +ve, PSA -ve, [[p63]] +ve, [[CK20]] +ve.		*UCC: GATA3 +ve, PSA -ve, [[p63]] +ve, [[CK20]] +ve.
	*Prostate: [[PSA]] +ve, [[GATA3]] -ve, [[PSAP]] +ve, CK7 -ve, CK20 -ve, p63 -ve.		*Prostate: [[PSA]] +ve, [[GATA3]] -ve, [[PSAP]] +ve, CK7 -ve, CK20 -ve, p63 -ve.

	UCC vs. [[renal cell carcinoma\|~~RCC~~]]:		UCC vs. [[renal cell carcinoma\|renal cell carcinoma]]:
	*UCC: p63 +ve.<ref>{{Cite journal \| last1 = Langner \| first1 = C. \| last2 = Ratschek \| first2 = M. \| last3 = Tsybrovskyy \| first3 = O. \| last4 = Schips \| first4 = L. \| last5 = Zigeuner \| first5 = R. \| title = P63 immunoreactivity distinguishes upper urinary tract transitional-cell carcinoma and renal-cell carcinoma even in poorly differentiated tumors. \| journal = J Histochem Cytochem \| volume = 51 \| issue = 8 \| pages = 1097-9 \| month = Aug \| year = 2003 \| doi = \| PMID = 12871991 }}		*UCC: p63 +ve.<ref>{{Cite journal \| last1 = Langner \| first1 = C. \| last2 = Ratschek \| first2 = M. \| last3 = Tsybrovskyy \| first3 = O. \| last4 = Schips \| first4 = L. \| last5 = Zigeuner \| first5 = R. \| title = P63 immunoreactivity distinguishes upper urinary tract transitional-cell carcinoma and renal-cell carcinoma even in poorly differentiated tumors. \| journal = J Histochem Cytochem \| volume = 51 \| issue = 8 \| pages = 1097-9 \| month = Aug \| year = 2003 \| doi = \| PMID = 12871991 }}
	</ref>		</ref>

	Metastatic UCC versus primary lung ~~SCC~~:		Metastatic UCC versus primary lung squamous cell carcinoma:
	*See ''[[Squamous_cell_carcinoma_of_the_lung#Lung_SCC_versus_metastatic_bladder_urothelial_carcinoma]]''.		:See ''[[Squamous_cell_carcinoma_of_the_lung#Lung_SCC_versus_metastatic_bladder_urothelial_carcinoma]]''.

	Note:		Note:

← Older revision		Revision as of 20:44, 3 February 2017
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	www:		www:
	*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282447/figure/F2/ Several images of NUCC (nih.gov)].<ref name=pmid22355497>{{Cite journal \| last1 = Terada \| first1 = T. \| title = Nested variant of urothelial carcinoma of the urinary bladder. \| journal = Rare Tumors \| volume = 3 \| issue = 4 \| pages = e42 \| month = Oct \| year = 2011 \| doi = 10.4081/rt.2011.e42 \| PMID = 22355497 \| PMC = 3282447 }}</ref>		*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282447/figure/F2/ Several images of NUCC (nih.gov)].<ref name=pmid22355497>{{Cite journal \| last1 = Terada \| first1 = T. \| title = Nested variant of urothelial carcinoma of the urinary bladder. \| journal = Rare Tumors \| volume = 3 \| issue = 4 \| pages = e42 \| month = Oct \| year = 2011 \| doi = 10.4081/rt.2011.e42 \| PMID = 22355497 \| PMC = 3282447 }}</ref>

			[[File:5 410253052 sl 1.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 2.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 3.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 4.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 5.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 6.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 7.png\| High grade urothelial carcinoma]]
			[[File:5 410253052 sl 8.png\| High grade urothelial carcinoma]]<br>
			High grade urothelial carcinoma in a 43 year old man. A. At low power, necrosis is seen, luminal, with viable invasive tumor elsewhere. B. Tumor partly fills right ureteral orifice. C. Tumor cells sometimes form Indian files (black arrows), appear to have nuclei that mold (red arrows), and have granular chromatin (cyan arrows), raising possibility of neuroendocrine carcinoma. D. Tumor invades lymphatic spaces. E. Urothelial carcinoma in situ is present. F,G,H. Tumor cells are diffusely positive for CK7, focally positive for CDX2, and diffusely positive for P40, with no positivity for chromogranin or synaptophysin.

	=[[IHC]]=		=[[IHC]]=