urothelial carcinoma

Types

 non-invasive urothelial carcinoma

• non-invasive papillary urothelial carcinoma
• non-invasive flat urothelial carcinoma / urothelial carcinoma in situ

  invasive urothelial carcinoma

Variants

 glandular urothelial carcinoma
 microscystic urothelial carcinoma
 micropapillary urothelial carcinoma
 nested urothelial carcinoma
 lymphoepithelioma-like urothelial carcinoma
 small tubules urothelial carcinoma
 inverted urothelial carcinoma
 sarcomatoid urothelial carcinoma
 small cell urothelial carcinoma
 rhabdoid cell urothelial carcinoma
 lipoid-rich cell urothelial carcinoma
 trophoblastic urothelial carcinoma
 osteoclast-rich urothelial carcinoma
 plasmacytoid urothelial carcinoma
 clear cell urothelial carcinoma
 gial cell urothelial carcinoma

• https://www.nature.com/modpathol/journal/v22/n2s/pdf/modpathol200926a.pdf

Immunochemistry

 positive IHC

• CK7, CK20 (50%), HMW keratin (80%)
• GATA3
• uroplakin (40-60%, but highly specific),
• thrombomodulin (Am J Surg Pathol 2003;27:1),
• variable p63
• MUC1, CEA, p53, S100
• Variable CA125 (Int J Biol Markers 1994;9:224), variable HER2
• CD31, CD34, and podoplanin (D2-40) are useful to distinguish true lymphatic invasion from retraction artifact, particularly in micropapillary variant

Note: keratin may stain non-tumor cells in repeat biopsy cases (Am J Surg Pathol 2007;31:390)

Note: CK20 staining pattern in primary tumor is replicated in metastases (Arch Pathol Lab Med 2001;125:921)

 negative IHC

• prostatic markers PSA, P501S, PSMA, NKX3.1 and pPSA (Am J Surg Pathol 2007;31:1246)
• WT1, MUC2, MUC5AC (Am J Clin Pathol 2004;122:61), HPV, Leu7/CD57

See also

  carcinomas

Open references

 Histological variants of urothelial carcinoma:
diagnostic, therapeutic and prognostic
implications. 2009. https://www.nature.com/modpathol/journal/v22/n2s/pdf/modpathol200926a.pdf