Abstract
Microcystic urothelial cell carcinoma is a rare variant of urothelial cell carcinoma which occurs in the bladder and, rarely, in the renal pelvis. Neuroendocrine differentiation is uncommon in pure urothelial carcinoma and is more frequently found in neoplasms with glandular differentiation. We report a case of microcystic urothelial cell carcinoma arising in renal pelvis and showing focal neuroendocrine differentiation. A 55-year-old man with a history of non-small cell cancer of the lung presented with abdominal pain and hematuria. Imaging studies and gross examination revealed a partially cystic mass in the left kidney. Microscopic examination disclosed invasive carcinoma with prominent microcystic features, with microcysts lined by low columnar and flat cells. Immunohistochemical analysis confirmed the urothelial histotype (positive for thrombomodulin, p63 and high-molecular-weight cytokeratins) and disclosed focal neuroendocrine differentiation.
References
Perez-Montiel D, Wakely PE, Hes O (2006) High-grade urothelial carcinoma of the renal pelvis: clinicopathologic study of 108 cases with emphasis on unusual morphologic variants. Mod Pathol 19:494–503
Young RH, Zukerberg LR (1991) Microcystic transitional cell carcinomas of the urinary bladder. A report of four cases. Am J Clin Pathol 96:635–639
Paz A, Rath-Wolfson L, Lask D et al (1997) The clinical and histological features of transitional cell carcinoma of the bladder with microcysts: analysis of 12 cases. Br J Urol 79:722–725
Leroy X, Leteurtre E, De La Taille A et al (2002) Microcystic transitional cell carcinoma: a report of 2 cases arising in the renal pelvis. Arch Pathol Lab Med 126:859–861
Radopoulos D, Kalyvas K, Kotakidou R et al (2005) Case report: microcystic transitional cell carcinoma of the urinary bladder. Int Urol Nephrol 37:291–293
Bollito ER, Pacchioni D, Lopez-Beltran A et al (2005) Immunohistochemical study of neuroendocrine differentiation in primary glandular lesions and tumors of the urinary bladder. Anal Quant Cytol Histol 27:218–224
Parker DC, Folpe AL, Bell J et al (2003) Potential utility of uroplakin III, thrombomodulin, high molecular weight cytokeratin, and cytokeratin 20 in noninvasive, invasive, and metastatic urothelial (transitional cell) carcinomas. Am J Surg Pathol 27:1–10
Langner C, Ratschek M, Tsybrovskyy O et al (2003) P63 immunoreactivity distinguishes upper urinary tract transitional-cell carcinoma and renal-cell carcinoma even in poorly differentiated tumors. J Histochem Cytochem 51:1097–1099
Lopez-Beltran A, Sauter G, Gasser T (2004) Infiltrating urothelial carcinoma. In: Eble JN, Sauter G, Epstein JI, et al (eds) Tumours of the urinary system and male genital organs. Lyon, World Health Organization Classification of Tumours, pp 93–109
Drew PA, Furman J, Civantos F et al (1996) The nested variant of transitional cell carcinoma: an aggressive neoplasm with innocuous histology. Mod Pathol 9:989–994
Pusztaszeri M, Hauser J, Iselin C et al (2007) Urothelial carcinoma “nested variant” of renal pelvis and ureter. Urology 69:778
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Pacchioni, D., Bosco, M., Allia, E. et al. Microcystic urothelial cell carcinoma with neuroendocrine differentiation arising in renal pelvis. Report of a case. Virchows Arch 454, 223–227 (2009). https://doi.org/10.1007/s00428-008-0693-7
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DOI: https://doi.org/10.1007/s00428-008-0693-7