Variants of Bladder Cancer: The Pathologist's Point of View (original) (raw)
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Variants and new entities of bladder cancer
Histopathology, 2018
Pathological evaluation of bladder cancer typically reveals great tumour heterogeneity, and therefore the common observation of urothelial carcinoma exhibiting a wide variety of histopathological patterns is not surprising. Some of these patterns are so distinctive that they have been recognised as specific variants of urothelial carcinoma. Classifications have recently been revised in the 2016 World Health Organisation (WHO) classification of tumours of the urinary system and male genital organs. The current WHO classifications clarify terminological issues and provide better definition criteria, but also incorporate some new entities. Many of these variants have important prognostic or therapeutic implications worth knowing by the urologist and oncologist, but also represent diagnostic challenges in daily pathology practice. This review will discuss the features of variants of urothelial carcinoma in the context of our current clinical practice. Histological variations and new ent...
Histopathology of urinary bladder carcinoma: Less common variants
Srpski arhiv za celokupno lekarstvo, 2011
Bladder cancer is a common form of neoplasia which most often presents histologically as urothelial (transitional cell) carcinoma. In this article we review recent publications dealing with the less common variants of urothelial carcinoma such as tumours that show unusual forms of differentiation or the well know squamous, glandular, or sarcomatoid differentiation. Urothelial tumours may also show several distinct growth variants characterized by a nested, micropapillary, lymphoepithelioma-like, or plasmacytoid and giant cell growth pattern. The clinical course of bladder cancer varies depending on the histological type of neoplasia, grade and stage of the tumour. High-grade muscle-invasive urothelial cancers and tumours showing variant microscopic morphology have in general high mortality and poor prognosis.
A varied morphological spectrum of urinary bladder carcinoma - A rare diagnostic entity
IP innovative publication pvt. ltd, 2019
Bladder carcinoma is the seventh most common malignancy worldwide and multiple risk factors have been linked to bladder cancer. Urothelial carcinoma accounts for the most common histological subtype and has a propensity for divergent differentiation. The clinical outcome of some of the variants differs from the typical urothelial carcinoma and recognition of these variants is pertinent. Primary small cell carcinoma is an extremely rare malignant neoplasm which accounts for less than 1% of urinary bladder cancer. We present two cases of bladder carcinoma in elderly men with varied histomorphological subtypes which posed a diagnostic challenge.
Histopathological Evaluation of Patients with Bladder Urothelial Carcinoma Diagnosed in Our Clinic
Istanbul Medical Journal, 2017
In our study, the age and gender of patients and the stage and grade of conventional bladder urothelial carcinoma (UC) and bladder UC variants were investigated. Methods: Patients with UC diagnosed in our pathology clinic between 2010 and 2015 were identified using an electronic database. They were reexamined according to the World Health Organization 2004 (WHO) classification system, and the grade and stage of UC and concomitant UC variants were documented for each patient. In addition to these data, the age and gender of each patient were obtained from the electronic database. Results: Between 2010 and 2015, 1355 biopsies from 1081 different patients were present with the diagnosis of UC. Totally, 676 patients with recurrence were excluded. Finally, 679 patients were included. When all patients were screened in terms of newly identified variants in the WHO 2004 classification system, 153 patients (22.6%) had UC variants, forming at least 10% of the biopsy specimen. We identified 15 UC variants: squamous differentiation, glandular differentiation, and small cell, micropapillary, sarcomatoid, lymphoepithelioma-like, nested, large nested, large cell neuroendocrine, plasmacytoid, pleomorphic, trophoblastic, rhabdoid, chordoid, and undifferentiated carcinomas. Conclusion: Our study is the largest case series on UC in Turkey. Due to the large number of patients, we believe that the results reflect the present status of the frequency and stage of UC variants and the gender and age of patients at diagnosis.
The Histological Variants of Urothelial Carcinoma of the Bladder: It Is Affecting the Prognosis?
Open Journal of Pathology, 2020
Urothelial carcinomas (UC) are likely to have particular morphological features that distinguish them from the typical form. These original aspects are called "histological variants of urothelial carcinoma". They can constitute all or part of the tumor and concern mainly muscle invasive UC and high grade. Their frequency varies according to the type, but the knowledge of these variants is essential because of the diagnostic difficulties, and the implication of their presence on the prognosis.
Contemporary bladder cancer: variant histology may be a significant driver of disease
Urologic oncology, 2015
To evaluate pathologic and survival outcomes among patients with variant histology (VH) urothelial carcinoma of the bladder. A retrospective review of an institutional database was performed to identify all patients who underwent radical cystectomy with curative intent for urothelial carcinoma between 2008 and June 2013. VH was assigned by genitourinary pathologists. Descriptive statistics comparing clinicopathologic outcomes were performed using the Pearson chi-square test and analysis of variance. Survival was evaluated using the Kaplan-Meier methodology and the Cox proportional hazards regression. In total, 624 patients were identified. Overall, 26% (n = 162) had VH, with the most common being squamous differentiation (n = 68), micropapillary variant (MPV, n = 28), plasmacytoid variant (PCV, n = 25), and sarcomatoid variant (n = 15); 64% of MPV and 72% of PCV had positive lymph nodes. Compared with 8% of patients with a non VH, 44% of those with VH were categorized as pT4 (P<0...
Variant forms of bladder cancer: basic considerations on treatment approaches
2011
Variant forms of bladder cancer are non-urothelial neoplasms or urothelial carcinomas mixed with other histologies. Compared to pure urothelial carcinoma, they all present with a high stage and grade. Prognosis is variable and there is a lack of evidence regarding the ideal treatment approach, because of their relative infrequency and the noninclusion in bladder cancer randomized trials. Despite this, basic recommendations can be extracted from case series. In the present report, existent literature about variant forms of bladder cancer is reviewed with focus on the most frequent: squamous cell, adenocarcinoma, small cell, micropapillary, sarcomatoid, and lymphoepithelioma-like.
Urology, 2014
OBJECTIVE To evaluate the concordance and prognostic role of histologic variants of bladder urothelial carcinoma in transurethral resection of bladder tumor (TURBT) and radical cystectomy (RC) specimens. METHODS Clinicopathologic information available at the time of RC and follow-up data from 4110 RC specimens, collected between January 2000 and December 2009 at 17 tertiary referral centers were retrospectively analyzed and evaluated for the presence or absence of uncommon variants of bladder urothelial carcinoma. The presence or absence of uncommon variants of bladder urothelial carcinoma was evaluated on previous TURBT specimens of patients undergoing RC. Cox regression was used to assess the impact of these parameters on cancer-specific survival, and the Kaplan-Meier test for disease-free survival was plotted for survival estimate. RESULTS Of 4110 patients, 579 were found to have uncommon variants of bladder urothelial carcinoma at RC (14.1%), whereas 266 (6.4%) at TURBT. A lack of agreement about uncommon variants was observed between TURBT and RC specimens in the entire population (P <.001). The presence of uncommon variants at TURBT was associated with an increased risk of pathologic upstage (hazard ratio, 3.24; confidence interval, 1.19-6.37; P <.003) and significant decrease in cancerspecific survival and recurrence-free survival (P <.001). CONCLUSION Although the concordance of presence of uncommon histologic variants of urothelial bladder carcinoma between TURBT and RC is low, the presence of uncommon histologic variants of urothelial bladder carcinoma at TURBT is associated with a less favorable clinical outcome. UROLOGY 84: 1141e1146, 2014.