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Invasive micropapillary carcinoma of urinary bladder: a clinicopathological study.
Indian J Pathol Microbiol. 2015 Jan-Mar; 58(1):2-6.IJ

Abstract

CONTEXT

Micropapillary variant of urothelial carcinoma (MPUC) is a rare but well-recognized tumor of the urinary bladder. Tumors with micropapillary areas accompanying conventional urothelial carcinoma are more aggressive compared to conventional urothelial carcinoma and show variable keratin 7, keratin 20 and human epidermal growth factor receptor 2 (Her 2)neu expression.

AIM

The aim of the study was to analyze the clinical, morphological and immunohistochemical profile of MPUC.

MATERIALS AND METHODS

Transurethral resection of bladder tumor (TURBT) chips of seven cases of invasive MPUC with subsequent cystoprostatectomy specimens of five patients was reviewed. Epithelial membrane antigen (EMA), Keratin 7, Keratin 20, and Her 2 immunohistochemistry were performed in all cases. Follow-up information was available for all patients (2-36 months).

RESULTS

All seven patients were male, and their ages ranged from 50 to 62 years. All cases presented with hematuria. The micropapillary pattern was seen in 20-95% of the tumor. All cases showed extensive lymphatic emboli with detrusor muscle invasion. Lymph node metastasis was present in all cases undergoing cystoprostatectomy except one. Keratin 7 and abluminal pattern of EMA positivity were seen in all cases. Keratin 20 was positive in five cases (71%), and Her 2neu positivity was seen in four cases. Three patients died 2, 3, and 6 months after initial diagnosis, among which two were Her 2 positive and one was Her 2 negative. There was no clear prognostic significance of Her 2 positivity.

CONCLUSION

(1) MPUC is a rare but highly aggressive tumor. (2) Micropapillary is usually the predominant pattern. (3) Keratin 7 is expressed universally, whereas Keratin 20 expression is variable. (4) Her 2 expression has no clear influence on the survival.

Authors+Show Affiliations

No affiliation info availableDepartment of Histopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25673582

Citation

Chatterjee, Debajyoti, et al. "Invasive Micropapillary Carcinoma of Urinary Bladder: a Clinicopathological Study." Indian Journal of Pathology & Microbiology, vol. 58, no. 1, 2015, pp. 2-6.
Chatterjee D, Das A, Radotra BD. Invasive micropapillary carcinoma of urinary bladder: a clinicopathological study. Indian J Pathol Microbiol. 2015;58(1):2-6.
Chatterjee, D., Das, A., & Radotra, B. D. (2015). Invasive micropapillary carcinoma of urinary bladder: a clinicopathological study. Indian Journal of Pathology & Microbiology, 58(1), 2-6. https://doi.org/10.4103/0377-4929.151153
Chatterjee D, Das A, Radotra BD. Invasive Micropapillary Carcinoma of Urinary Bladder: a Clinicopathological Study. Indian J Pathol Microbiol. 2015 Jan-Mar;58(1):2-6. PubMed PMID: 25673582.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Invasive micropapillary carcinoma of urinary bladder: a clinicopathological study. AU - Chatterjee,Debajyoti, AU - Das,Ashim, AU - Radotra,Bishan D, PY - 2015/2/13/entrez PY - 2015/2/13/pubmed PY - 2015/9/1/medline SP - 2 EP - 6 JF - Indian journal of pathology & microbiology JO - Indian J Pathol Microbiol VL - 58 IS - 1 N2 - CONTEXT: Micropapillary variant of urothelial carcinoma (MPUC) is a rare but well-recognized tumor of the urinary bladder. Tumors with micropapillary areas accompanying conventional urothelial carcinoma are more aggressive compared to conventional urothelial carcinoma and show variable keratin 7, keratin 20 and human epidermal growth factor receptor 2 (Her 2)neu expression. AIM: The aim of the study was to analyze the clinical, morphological and immunohistochemical profile of MPUC. MATERIALS AND METHODS: Transurethral resection of bladder tumor (TURBT) chips of seven cases of invasive MPUC with subsequent cystoprostatectomy specimens of five patients was reviewed. Epithelial membrane antigen (EMA), Keratin 7, Keratin 20, and Her 2 immunohistochemistry were performed in all cases. Follow-up information was available for all patients (2-36 months). RESULTS: All seven patients were male, and their ages ranged from 50 to 62 years. All cases presented with hematuria. The micropapillary pattern was seen in 20-95% of the tumor. All cases showed extensive lymphatic emboli with detrusor muscle invasion. Lymph node metastasis was present in all cases undergoing cystoprostatectomy except one. Keratin 7 and abluminal pattern of EMA positivity were seen in all cases. Keratin 20 was positive in five cases (71%), and Her 2neu positivity was seen in four cases. Three patients died 2, 3, and 6 months after initial diagnosis, among which two were Her 2 positive and one was Her 2 negative. There was no clear prognostic significance of Her 2 positivity. CONCLUSION: (1) MPUC is a rare but highly aggressive tumor. (2) Micropapillary is usually the predominant pattern. (3) Keratin 7 is expressed universally, whereas Keratin 20 expression is variable. (4) Her 2 expression has no clear influence on the survival. SN - 0974-5130 UR - https://www.unboundmedicine.com/medline/citation/25673582/Invasive_micropapillary_carcinoma_of_urinary_bladder:_a_clinicopathological_study_ L2 - http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2015;volume=58;issue=1;spage=2;epage=6;aulast=Chatterjee DB - PRIME DP - Unbound Medicine ER -