Clinicopathologic analysis of upper urinary tract carcinoma with variant histology

Inês Rolim, Vanessa Henriques, Nídia Rolim, Ana Blanca, Rita Canas Marques, Metka Volavšek, Inês Carvalho, Rodolfo Montironi, Alessia Cimadamore, Maria R. Raspollini, Liang Cheng, Antonio Lopez-Beltran

Research output: Contribution to journalArticlepeer-review


We report on the clinicopathologic features of 115 cases of high-grade urothelial carcinoma of the upper urinary tract with variant histology present in 39 (34%). Variant histology was typically seen in high pathological stage (pT2-pT4) (82%, 32 cases) patients with lower survival rate (70%, 27 cases, median survival 31 months) and consisted in urothelial with one (23%), two (3%), and three or more variants (3%); 4% of cases presented with pure variant histology. Squamous divergent differentiation was the most common variant (7%) followed by sarcomatoid (6%) and glandular (4%), followed by 3% each of micropapillary, diffuse-plasmacytoid, inverted growth, clear cell glycogenic, or lipid-rich. The pseudo-angiosarcomatous variant is seen in 2%, and 1% each of nested, giant-cell, lymphoepithelioma-like, small-cell, trophoblastic, rhabdoid, microcystic, lymphoid-rich stroma, or myxoid stroma/chordoid completed the study series. Loss of mismatch repair protein expression was identified in one case of upper urinary tract carcinoma with inverted growth variant (3.6%). Variant histology was associated to pathological stage (p = 0.007) and survival status (p = 0.039). The univariate survival analysis identified variant histology as a feature of lower recurrence-free survival (p = 0.046). Our findings suggest that variant histology is a feature of aggressiveness in urothelial carcinoma of the upper urinary tract worth it to be reported.

Original languageEnglish (US)
Pages (from-to)111-120
Number of pages10
JournalVirchows Archiv
Issue number1
StatePublished - Jul 1 2020


  • Divergent
  • Glandular
  • MMR
  • Micropapillary
  • Nested
  • Plasmacytoid
  • Renal pelvis
  • Sarcomatoid
  • Squamous
  • Ureter
  • Urothelial carcinoma
  • Variant histology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Molecular Biology
  • Cell Biology

Fingerprint Dive into the research topics of 'Clinicopathologic analysis of upper urinary tract carcinoma with variant histology'. Together they form a unique fingerprint.

Cite this