Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD 21231, USA.
Hum Pathol. 2012 Dec;43(12):2124-8. doi: 10.1016/j.humpath.2012.04.013. Epub 2012 Aug 30.
Noninvasive micropapillary urothelial carcinoma consists of slender tufts of urothelial carcinoma lacking fibrovascular cores analogous to ovarian papillary serous tumors of borderline malignancy. Eighteen noninvasive micropapillary urothelial carcinoma cases were identified from the Pathology Department of The Johns Hopkins Hospital (2000-2011). Patients lacked history of invasive urothelial carcinoma. Two patterns of noninvasive micropapillary urothelial carcinoma were identified: (1) as a variant of noninvasive high-grade papillary urothelial carcinoma (high-grade papillary urothelial carcinoma/micropapillary urothelial carcinoma) (n = 13 cases) and (2) as a variant of urothelial carcinoma in situ (carcinoma in situ/micropapillary urothelial carcinoma) (n = 5 cases with 2 of these patients also having high-grade papillary urothelial carcinoma/micropapillary urothelial carcinoma). Of 18 patients, 16 (88%) were male with a mean age of 71.8 years (range, 54-87 years). Of the 12 patients initially treated with surveillance, Bacillus-Calmette Guérin, or intravesical chemotherapy, 4 did not recur and were without evidence of disease at 6, 21, 24, and 39 months. Four patients experienced recurrences with 3 of them without evidence of disease at 36, 52, and 72 months and with the fourth whose last follow-up was at 84 months when recurrence occurred. One patient is alive at 11 months with disease, and 1 died of other causes at 1 month. Two patients progressed to pT2 and pT3 disease at 5 and 21 months, respectively. It is critical to differentiate and clearly specify in pathology reports whether micropapillary urothelial carcinoma is invasive or noninvasive because invasive micropapillary urothelial carcinoma is an aggressive disease with a high degree of understaging, whereas some cases of noninvasive micropapillary urothelial carcinoma are not necessarily associated with an adverse outcome.
非浸润性微乳头状尿路上皮癌由缺乏类似交界性卵巢乳头状浆液性肿瘤纤维血管核心的尿路上皮癌细长绒毛组成。从约翰霍普金斯医院病理学系（2000-2011 年）确定了 18 例非浸润性微乳头状尿路上皮癌病例。患者无浸润性尿路上皮癌病史。鉴定出两种非浸润性微乳头状尿路上皮癌模式：（1）作为非浸润性高级别乳头状尿路上皮癌（高级别乳头状尿路上皮癌/微乳头状尿路上皮癌）的变体（n=13 例）和（2）作为原位尿路上皮癌（原位癌/微乳头状尿路上皮癌）的变体（n=5 例，其中 2 例也有高级别乳头状尿路上皮癌/微乳头状尿路上皮癌）。18 例患者中，16 例（88%）为男性，平均年龄 71.8 岁（范围，54-87 岁）。在最初接受监测、卡介苗或膀胱内化疗治疗的 12 例患者中，4 例未复发，6、21、24 和 39 个月时无疾病证据。4 例患者出现复发，其中 3 例 36、52 和 72 个月时无疾病证据，第 4 例患者在 84 个月时复发。1 例患者存活 11 个月伴疾病，1 例患者因其他原因在 1 个月时死亡。2 例患者分别在 5 个月和 21 个月进展为 pT2 和 pT3 疾病。在病理报告中区分并明确指定微乳头状尿路上皮癌是浸润性还是非浸润性至关重要，因为浸润性微乳头状尿路上皮癌是一种侵袭性疾病，存在高度低估分期的情况，而一些非浸润性微乳头状尿路上皮癌病例不一定与不良预后相关。
