Division of Histology and Molecular Diagnostics, University Hospital Careggi, Viale G.B. Morgagni, Florence, Italy 50134.
Hum Pathol. 2011 Aug;42(8):1149-58. doi: 10.1016/j.humpath.2010.11.011. Epub 2011 Feb 21.
A plasmacytoid variant of urothelial carcinoma has been recently recognized in the World Health Organization classification system. This is characterized by a discohesive growth of plasmacytoid cells with eccentric nuclei, extending in the bladder wall and often in the perivesical adipose tissue. Herein, we report the clinicopathologic, immunohistochemical, ultrastructural, and molecular features of a series of plasmacytoid urothelial carcinoma of the urinary bladder. Four bladder carcinomas characterized by epithelial cells with morphologic appearance resembling plasma cells were evaluated at the immunohistochemical, electron microscopic, and molecular genetic levels. Tumor cells stained with cytokeratins, epithelial membrane antigen, GATA-3 (endothelial transcription factor 3), CD15, p53, and p16. In addition, malignant cells strongly stained with CD138 in all the cases, whereas leukocyte common antigen and multiple myeloma 1/interferon regulatory factor 4 were completely negative, nor immunoreactivity was seen for either κ or λ light chains. The electron microscopic examination showed the presence of divergent squamous and glandular differentiation. At variance with conventional urothelial carcinoma, the analysis of exons 4-9 of TP53 gene revealed no alteration in all the 4 tumors tested, and this can be of value in choosing additional chemotherapy after surgery. Plasmacytoid carcinoma of the bladder is a tumor entity, which can be characterized by specific immunohistochemical markers, including positivity for GATA-3, and presents phenotypic and genotypic peculiarities.
最近在世界卫生组织分类系统中认识到尿路上皮癌的浆母细胞变体。 其特征为浆母细胞的离散生长，具有偏心核，在膀胱壁中延伸，并且经常在膀胱周围脂肪组织中延伸。 在此，我们报告了一系列膀胱浆母细胞尿路上皮癌的临床病理，免疫组织化学，超微结构和分子特征。 在免疫组织化学，电子显微镜和分子遗传学水平上评估了 4 种具有类似于浆细胞形态的上皮细胞的膀胱癌。 肿瘤细胞用细胞角蛋白，上皮膜抗原，GATA-3（内皮转录因子 3），CD15，p53 和 p16 染色。 此外，在所有病例中恶性细胞均强烈染色 CD138，而白细胞共同抗原和多发性骨髓瘤 1/干扰素调节因子 4完全阴性，κ 或 λ 轻链也没有免疫反应性。 电子显微镜检查显示存在不同的鳞状和腺体分化。 与常规尿路上皮癌不同，在所有 4 个测试肿瘤中，TP53 基因外显子 4-9 的分析均未发现改变，这对于手术后选择其他化疗具有重要意义。 膀胱浆母细胞瘤是一种肿瘤实体，可以通过特定的免疫组织化学标志物来特征化，包括 GATA-3 的阳性表达，并表现出表型和基因型的特征。
