Nabbout Philippe, Furr James, Paari Murugan, Slobodov Gennady
Department of Urology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
Case Rep Urol. 2012;2012:715951. doi: 10.1155/2012/715951. Epub 2012 Aug 16.
Introduction. Plasmacytoid urothelial carcinoma (PUC) of the bladder is a rare histological variant of urothelial carcinoma that was recently identified. Available data on this histological variant is limited. Case Report. We report the case of a 75-year-old man with presumed history of high-grade urothelial cancer of the bladder, treated with transurethral resection and Bacille Calmette-Guérin (BCG) in 2004. Six years after treatment of the bladder cancer, the patient underwent gastrectomy for an undifferentiated carcinoma of the stomach. On followup, patient developed right ureterohydronephrosis and peritoneal carcinomatosis. Biopsy of the bladder during stent placement revealed a plasmacytoid urothelial carcinoma of the bladder. Rereadings revealed that the initial bladder and gastric malignancies were also plasmacytoid carcinoma, indicating that, the patient had since 2004, a PUC of the bladder that spread to the stomach and peritoneal cavity. Conclusion. Plasmacytoid urothelial carcinoma of the bladder is an aggressive variant of urothelial carcinoma. Based on our case and the literature review, this tumor can be misdiagnosed because of its rarity, leading to treatment delays. Both the urologist and the pathologist need to have a high index of suspicion for PUC whenever they encounter unusual clinical and/or pathological findings.
引言。膀胱浆细胞样尿路上皮癌（PUC）是一种最近才被发现的尿路上皮癌罕见组织学变异类型。关于这种组织学变异类型的现有数据有限。病例报告。我们报告一例75岁男性病例，该患者既往疑似患有高级别膀胱尿路上皮癌，2004年接受了经尿道切除术和卡介苗（BCG）治疗。膀胱癌治疗6年后，患者因胃未分化癌接受了胃切除术。随访期间，患者出现右侧输尿管肾盂积水和腹膜癌转移。在放置支架期间对膀胱进行活检，结果显示为膀胱浆细胞样尿路上皮癌。再次阅片发现最初的膀胱和胃部恶性肿瘤也是浆细胞样癌，这表明自2004年起，该患者患有膀胱PUC，且已扩散至胃和腹腔。结论。膀胱浆细胞样尿路上皮癌是尿路上皮癌的一种侵袭性变异类型。基于我们的病例及文献回顾，由于其罕见性，这种肿瘤可能会被误诊，从而导致治疗延误。每当泌尿外科医生和病理科医生遇到不寻常的临床和/或病理表现时，都需要对PUC保持高度的怀疑指数。
