Plasmacytoid urothelial carcinoma of the urinary bladder : a clinicopathologic analysis
ZHANG Yu-tao
ZHOU Hong-yuan
LI Hong
Abstract：Objective To explore clinicopathologic characteristic,differential diagnosis,therapy and prognosis of plasmacytoid urothelial carcinoma (PUC) of the urinary bladder.Methods Clinical data for a case of PUC was analyzed.Histopathologic appearance and immunophenotype were observed.Differential diagnosis was discussed and related literatures were reviewed.Results The male patient was 54 years old.The man presented with whole range painless gross hematuria without obvious motivation.Both ultrasonic inspection and computed tomography scan prompted a bladder tumor.Cystoscopy showed a papillary-growing tumor with a wide-based stalk on the left lateral wall of urinary bladder.And the tumor located in left lateral wall of bladder which was 2 cm from ureteric orifice during operation.Cross section was grayish-white and fragile.Microscopic view showed the tumor cells infiltrated into submucous layer and muscular layer of the bladder with diffuse,acinar and trabs-like pattern.Tumor cells that resemble plasma cells were discohesive and with a thick cytoplasm and eccentrically located nuclei.Nuclei atypia can be minimal and irregular,but mitosis was easy to be found.There were small fraction of tumor cells with large round nuclei and obvious nucleoli resembled lymphoma cells.These two kinds of tumor cells were mixed and without obvious boundary.Otherwise,there were still some tumor cells like signet ring cells,but no common urothelial carcinoma component.Immunohistochemical staining result showed the tumor cells were positive for P-CK,CK7,CK20,GATA-3,Uroplakin Ⅲ,P53,P63,CD138 and E-cadherin,but negative for CK5/6,LCA,CD38,CD20,CD79a,CD3,Vimentin,myogenin,myosin,CgA,Syn,CD68,CD99,HMB45,S-100 and PSA.Proliferation index for Ki-67 was about 50％.There were three times of recurrence in 55 months,74 months and 82 months respectively after first bladder tumor reseeting operation.The patient remained well now.Conclusion PUC is a rare subtype of urothelial carcinoma and has characteristic for fast invasion,high relapse rate and poor prognosis.Early discovery,diagnosis and therapy have important significance for elevating the patients' survival rate.It is helpful to value progression of disease and prognosis by detecting status of CA199 and Ecadherin.
Keywords：Urinary bladderPlasmacytoid urothelial carcinomaDifferential diagnosis
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 665-669 )