Wei Jianguo, Yue Zhenying, Song Dianhang, Wang Qiang, Teng Xiaodong
Department of Pathology, Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University) Shaoxing, Zhejiang Province, P. R China.
Department of Pathology, Shengli Oil Field Central Hospital Dongying, Shandong Province, P. R China.
Int J Clin Exp Pathol. 2015 Nov 1;8(11):15344-9. eCollection 2015.
Invasive urothelial carcinoma (UC) is characterized by some histologic variants that can sometimes lead to diagnostic difficulty. In addition to those described by the World Health Organization. Recently invasive urothelial carcinoma with chordoid features (UCC) has been described as a distinct entity and there are relatively few reported cases in the English-language literature. To date 13 cases of UCC have been reported in 2 case series, respectively in 2009 and 2015. We report the 14(th) case in an 80-year-old female, and to the best of our knowledge this is the second case report of UCC in the ureter. She was admitted to our hospital with macroscopic haematuria and unspecific left lower abdominal pain. Computed tomography scan revealed a soft tissue nodule in the middle of the left ureter. The left nephroureterectomy was performed. Morphologically, 85% areas had acellular myxoid stroma was associated with the neoplastic cells. The neoplastic cells had scant eosinophilic cytoplasm and were arranged into cords closely mimicking chordoma or extraskeletal myxoid chondrosarcoma. 15% areas was typical invasive urothelial carcinoma, and focal areas had transition phenomenon between them. Immunohistochemically, the tumor cells were positive for CK, 34βE12 and p63, but were negative for S100, AFP, CD34, Syn and CgA. The final histopathological diagnosis was UCC of the ureter.
浸润性尿路上皮癌（UC）具有一些组织学变异型，有时会导致诊断困难。除了世界卫生组织所描述的那些变异型外。最近，具有脊索样特征的浸润性尿路上皮癌（UCC）已被描述为一种独特的实体，并且英文文献中报道的病例相对较少。迄今为止，分别在2009年和2015年的2个病例系列中报道了13例UCC。我们报告了1例80岁女性的第14例病例，据我们所知，这是输尿管UCC的第二例病例报告。她因肉眼血尿和非特异性左下腹疼痛入院。计算机断层扫描显示左输尿管中段有一个软组织结节。进行了左肾输尿管切除术。形态学上，85%的区域有与肿瘤细胞相关的无细胞黏液样基质。肿瘤细胞胞质嗜酸性稀少，排列成条索状，酷似脊索瘤或骨外黏液样软骨肉瘤。15%的区域为典型的浸润性尿路上皮癌，且它们之间有局灶性过渡现象。免疫组化显示，肿瘤细胞CK、34βE12和p63阳性，但S100、AFP、CD34、Syn和CgA阴性。最终组织病理学诊断为输尿管UCC。
