Plasmacytoid/diffuse urothelial carcinoma

a single-institution immunohistochemical and molecular study of 69 patients

Carmen M. Perrino, John Eble, Chia Sui Kao, Rumeal D. Whaley, Liang Cheng, Muhammad Idrees, Neda Hashemi-Sadraei, M. Francesa Monn, Hristos Kaimakliotis, Elhaam Bandali, David Grignon

Research output: Contribution to journalArticle

Abstract

Accurate diagnosis of plasmacytoid urothelial carcinoma (PUC) is important given its poor prognosis and frequent presentation at high stage. We aim to assess the clinicopathological features, molecular aberrations, and follow-up data in a series of PUC cases from a single tertiary cancer center. Seventy-two urinary bladder, ureteral, and renal pelvic specimens with urothelial carcinoma with plasmacytoid differentiation were identified. Immunohistochemical stains were performed on 48 cases. Among urinary bladder origin markers, GATA3 was most sensitive (96%). Breast carcinoma markers (estrogen receptor, mammaglobin) were usually negative, but progesterone receptor stained 1 case (4%). Neuroendocrine markers CD56 and TTF-1 were each positive in 1 case (4% and 4%, respectively). Gastrointestinal adenocarcinoma marker CDX2 was positive in 4 cases (15%), but nuclear β-catenin was negative in all cases. CD138 was positive in 83% and E-cadherin expression was lost in 57% of cases. Fluorescence in situ hybridization using the UroVysion Bladder Cancer Kit and FGFR3 mutational analysis using polymerase chain reaction were performed on 15 cases; deletion of chromosome 9p21 was common (60%), and FGFR3 mutations were detected in 60% of cases (5 cases had both deletion 9p21 and FGFR3 mutations). Cases were divided into 3 morphologic groups: classic (29%), desmoplastic (35%), and pleomorphic (36%). The 3 morphologic subtypes had distinct survival outcomes (P =.083), with median survival for all patients 18 being months versus 10 months for the desmoplastic group.

Original languageEnglish (US)
Pages (from-to)27-36
Number of pages10
JournalHuman pathology
Volume90
DOIs
StatePublished - Aug 1 2019

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Carcinoma
Urinary Bladder
Catenins
Chromosome Deletion
Mutation
Survival
Progesterone Receptors
Cadherins
Fluorescence In Situ Hybridization
Urinary Bladder Neoplasms
Estrogen Receptors
Adenocarcinoma
Coloring Agents
Breast Neoplasms
Kidney
Polymerase Chain Reaction
Neoplasms

Keywords

  • Bladder
  • Diffuse
  • Plasmacytoid
  • Signet ring
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Plasmacytoid/diffuse urothelial carcinoma : a single-institution immunohistochemical and molecular study of 69 patients. / Perrino, Carmen M.; Eble, John; Kao, Chia Sui; Whaley, Rumeal D.; Cheng, Liang; Idrees, Muhammad; Hashemi-Sadraei, Neda; Monn, M. Francesa; Kaimakliotis, Hristos; Bandali, Elhaam; Grignon, David.

In: Human pathology, Vol. 90, 01.08.2019, p. 27-36.

Research output: Contribution to journalArticle

Perrino, Carmen M. ; Eble, John ; Kao, Chia Sui ; Whaley, Rumeal D. ; Cheng, Liang ; Idrees, Muhammad ; Hashemi-Sadraei, Neda ; Monn, M. Francesa ; Kaimakliotis, Hristos ; Bandali, Elhaam ; Grignon, David. / Plasmacytoid/diffuse urothelial carcinoma : a single-institution immunohistochemical and molecular study of 69 patients. In: Human pathology. 2019 ; Vol. 90. pp. 27-36.
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abstract = "Accurate diagnosis of plasmacytoid urothelial carcinoma (PUC) is important given its poor prognosis and frequent presentation at high stage. We aim to assess the clinicopathological features, molecular aberrations, and follow-up data in a series of PUC cases from a single tertiary cancer center. Seventy-two urinary bladder, ureteral, and renal pelvic specimens with urothelial carcinoma with plasmacytoid differentiation were identified. Immunohistochemical stains were performed on 48 cases. Among urinary bladder origin markers, GATA3 was most sensitive (96{\%}). Breast carcinoma markers (estrogen receptor, mammaglobin) were usually negative, but progesterone receptor stained 1 case (4{\%}). Neuroendocrine markers CD56 and TTF-1 were each positive in 1 case (4{\%} and 4{\%}, respectively). Gastrointestinal adenocarcinoma marker CDX2 was positive in 4 cases (15{\%}), but nuclear β-catenin was negative in all cases. CD138 was positive in 83{\%} and E-cadherin expression was lost in 57{\%} of cases. Fluorescence in situ hybridization using the UroVysion Bladder Cancer Kit and FGFR3 mutational analysis using polymerase chain reaction were performed on 15 cases; deletion of chromosome 9p21 was common (60{\%}), and FGFR3 mutations were detected in 60{\%} of cases (5 cases had both deletion 9p21 and FGFR3 mutations). Cases were divided into 3 morphologic groups: classic (29{\%}), desmoplastic (35{\%}), and pleomorphic (36{\%}). The 3 morphologic subtypes had distinct survival outcomes (P =.083), with median survival for all patients 18 being months versus 10 months for the desmoplastic group.",
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AU - Kao, Chia Sui

AU - Whaley, Rumeal D.

AU - Cheng, Liang

AU - Idrees, Muhammad

AU - Hashemi-Sadraei, Neda

AU - Monn, M. Francesa

AU - Kaimakliotis, Hristos

AU - Bandali, Elhaam

AU - Grignon, David

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KW - Bladder

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KW - Plasmacytoid

KW - Signet ring

KW - Urothelial carcinoma

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