The plasmacytoid carcinoma of the bladder-rare variant of aggressive urothelial carcinoma

Bastian Keck, Robert Stoehr, Sven Wach, Anja Rogler, Ferdinand Hofstaedter, Jan Lehmann, Rodolfo Montironi, Mathilde Sibonye, Hans M. Fritsche, Antonio Lopez-Beltran, Jonathan Ira Epstein, Bernd Wullich, Arndt Hartmann

Research output: Contribution to journalArticle

Abstract

The WHO 2004 classification defines new histological and molecular variants of urothelial carcinoma. However, there are limited data available on the clinicopathological characteristics or prognosis of these variants. We present histopathological, molecular and clinical data of 32 plasmacytoid carcinomas of the bladder (PUC) showing that PUC is a high-grade tumor with molecular features of aggressive urothelial carcinoma, usually diagnosed in advanced pathological stage (64% pT3, 23% pT4) showing metastases in 60% of the patients. Average survival of our cohort of PUC treated with radical cystectomy and adjuvant chemotherapy was lower than what is typically seen for comparable conventional urothelial carcinomas. Eighty-seven percent of the PUCs showed a negative or strongly reduced membranous staining of E-cadherin. b-Catenin staining was negative in 22.5%, and 16.7% of the remaining tumors showed nuclear accumulation. Aberrant CK20 expression (negative or >10% of cells stained) and negative CK7 staining was found in 100% and 22.6%, respectively. Ninety-seven percent revealed positive staining for PAN-CK. CD138 was positive in 78%, whereas MUM-1 expression was negative in all cases. Multitarget fluorescence in situ hybridization showed all PUCs to be highly aneuploid and polysomic. Deletions on chromosome 9p21 seem to play an important role in this variant. FGFR3 and PIK3CA mutation analyses yielded no mutations in any of the PUCs analyzed. TP53 mutation analysis showed mutations in 29%. In summary, PUC is an aggressive variant of bladder cancer with molecular features of advanced bladder cancer and evidence of WNT pathway activation in some of the cases.

Original languageEnglish (US)
Pages (from-to)346-354
Number of pages9
JournalInternational Journal of Cancer
Volume129
Issue number2
DOIs
StatePublished - Jul 15 2011

Fingerprint

Urinary Bladder
Carcinoma
Negative Staining
Mutation
Urinary Bladder Neoplasms
Staining and Labeling
Catenins
Chromosome Deletion
Cystectomy
Aneuploidy
Cadherins
Adjuvant Chemotherapy
Fluorescence In Situ Hybridization
Neoplasms
Neoplasm Metastasis
Survival

Keywords

  • Chemotherapy
  • FISH
  • Immunohistochemistry
  • Plasmacytoid
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Keck, B., Stoehr, R., Wach, S., Rogler, A., Hofstaedter, F., Lehmann, J., ... Hartmann, A. (2011). The plasmacytoid carcinoma of the bladder-rare variant of aggressive urothelial carcinoma. International Journal of Cancer, 129(2), 346-354. https://doi.org/10.1002/ijc.25700

The plasmacytoid carcinoma of the bladder-rare variant of aggressive urothelial carcinoma. / Keck, Bastian; Stoehr, Robert; Wach, Sven; Rogler, Anja; Hofstaedter, Ferdinand; Lehmann, Jan; Montironi, Rodolfo; Sibonye, Mathilde; Fritsche, Hans M.; Lopez-Beltran, Antonio; Epstein, Jonathan Ira; Wullich, Bernd; Hartmann, Arndt.

In: International Journal of Cancer, Vol. 129, No. 2, 15.07.2011, p. 346-354.

Research output: Contribution to journalArticle

Keck, B, Stoehr, R, Wach, S, Rogler, A, Hofstaedter, F, Lehmann, J, Montironi, R, Sibonye, M, Fritsche, HM, Lopez-Beltran, A, Epstein, JI, Wullich, B & Hartmann, A 2011, 'The plasmacytoid carcinoma of the bladder-rare variant of aggressive urothelial carcinoma', International Journal of Cancer, vol. 129, no. 2, pp. 346-354. https://doi.org/10.1002/ijc.25700
Keck, Bastian ; Stoehr, Robert ; Wach, Sven ; Rogler, Anja ; Hofstaedter, Ferdinand ; Lehmann, Jan ; Montironi, Rodolfo ; Sibonye, Mathilde ; Fritsche, Hans M. ; Lopez-Beltran, Antonio ; Epstein, Jonathan Ira ; Wullich, Bernd ; Hartmann, Arndt. / The plasmacytoid carcinoma of the bladder-rare variant of aggressive urothelial carcinoma. In: International Journal of Cancer. 2011 ; Vol. 129, No. 2. pp. 346-354.
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abstract = "The WHO 2004 classification defines new histological and molecular variants of urothelial carcinoma. However, there are limited data available on the clinicopathological characteristics or prognosis of these variants. We present histopathological, molecular and clinical data of 32 plasmacytoid carcinomas of the bladder (PUC) showing that PUC is a high-grade tumor with molecular features of aggressive urothelial carcinoma, usually diagnosed in advanced pathological stage (64{\%} pT3, 23{\%} pT4) showing metastases in 60{\%} of the patients. Average survival of our cohort of PUC treated with radical cystectomy and adjuvant chemotherapy was lower than what is typically seen for comparable conventional urothelial carcinomas. Eighty-seven percent of the PUCs showed a negative or strongly reduced membranous staining of E-cadherin. b-Catenin staining was negative in 22.5{\%}, and 16.7{\%} of the remaining tumors showed nuclear accumulation. Aberrant CK20 expression (negative or >10{\%} of cells stained) and negative CK7 staining was found in 100{\%} and 22.6{\%}, respectively. Ninety-seven percent revealed positive staining for PAN-CK. CD138 was positive in 78{\%}, whereas MUM-1 expression was negative in all cases. Multitarget fluorescence in situ hybridization showed all PUCs to be highly aneuploid and polysomic. Deletions on chromosome 9p21 seem to play an important role in this variant. FGFR3 and PIK3CA mutation analyses yielded no mutations in any of the PUCs analyzed. TP53 mutation analysis showed mutations in 29{\%}. In summary, PUC is an aggressive variant of bladder cancer with molecular features of advanced bladder cancer and evidence of WNT pathway activation in some of the cases.",
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