Gaafar A, Garmendia M, de Miguel E, Velasco V, Ugalde A, Bilbao F J, de Petris G, López J I
Departament de Anatomía Patológica, Hospital de Basurto.
Actas Urol Esp. 2008 Sep;32(8):806-10. doi: 10.1016/s0210-4806(08)73939-1.
Plasmacytoid urothelial carcinoma is a rare and aggressive variant of bladder cancer that mimics plasmacytoma histologically and that can be confused with hemolymphoid neoplasms secondarily affecting the urinary bladder. Only single cases and short series have been described so far.
Seven cases of plasmacytoid urothelial carcinoma have been found among 720 high grade urothelial carcinomas of the urinary bladder.
In our series, 0.97% of high grade urothelial carcinomas of the urinary bladder show plasmacytoid phenotype. All the cases were smoking males between 58 and 75 years old. Histologically, two cases showed pure plasmacytoid features, while in the other five cases the plasmacytoid phenotype was mixed with conventional transitional cell or glandular histologies. By immunohistochemistry, all the plasmacytoid areas showed fair epithelial differentiation. The clinical behaviour was aggressive in all the cases, with distant metastases at diagnosis in three cases and early tumor recurrence after chemotherapy in four of them.
In our experience, the plasmacytoid urothelial carcinoma of the urinary bladder is a rare tumor that can also be detected in association with areas of conventional urothelial carcinoma. It is mandatory to recognize this histological subtype due to the clinical and prognostic implications of this diagnosis.
浆细胞样尿路上皮癌是膀胱癌中一种罕见且侵袭性强的变异型，其在组织学上类似浆细胞瘤，可能与继发累及膀胱的血液淋巴系统肿瘤相混淆。目前仅有个别病例及小系列病例报道。
在720例膀胱高级别尿路上皮癌中发现7例浆细胞样尿路上皮癌。
在我们的病例系列中，0.97%的膀胱高级别尿路上皮癌表现为浆细胞样表型。所有病例均为58至75岁的吸烟男性。组织学上，2例表现为单纯浆细胞样特征，而其他5例中浆细胞样表型与传统移行细胞或腺性组织学混合存在。通过免疫组化，所有浆细胞样区域均显示出良好的上皮分化。所有病例的临床行为均具有侵袭性，3例在诊断时即有远处转移，其中4例在化疗后早期肿瘤复发。
根据我们的经验，膀胱浆细胞样尿路上皮癌是一种罕见肿瘤，也可与传统尿路上皮癌区域同时存在。鉴于该诊断的临床及预后意义，必须认识到这种组织学亚型。
