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Clinicopathological characteristics and outcome of nested carcinoma of the urinary bladder

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Abstract

We present the clinicopathological features of 56 cases of the nested variant of urothelial bladder carcinoma. This is an uncommon variant of bladder cancer, recognized by the current WHO classification of urologic tumors. The nested component represented 100 % of the tumor in 24 cases. The architectural pattern of the tumor varied from solid expansile to infiltrative nests characterized by deceptively bland histologic features resembling von Brunn nests. Typical features of high-grade conventional urothelial carcinoma were present in 32 cases. Most neoplastic cells had nuclei of low to intermediate nuclear grade with occasional nuclear enlargement, most frequently seen in deep areas of tumor. The nested component expressed cytokeratins 7, 20, CAM5.2, and high molecular weight (34ßE12), p63, Ki67, p53, p27, and GATA3. Tumor extension was T1 (n = 9), minimally T2 (n = 10), T2a (n = 1), T2b (n = 4), T3a (n = 8), T3b (n = 13), and T4a (n = 11). On follow-up, 36 of patients died of or were alive with disease from 2 to 80 months (mean 21 months). Four patients died of other causes. Eleven other patients remained disease free. Univariate survival analysis showed no differences for nested carcinoma compared with conventional urothelial carcinoma. As in conventional urothelial carcinoma, in nested carcinoma of the bladder pT category defined different survival groups. In summary, nested variant of urothelial bladder carcinoma is typically associated with advanced stage. In samples of limited volume, it may be misdiagnosed as proliferation of von Brunn nests or other nested-like bladder lesions, delaying definitive therapy.

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Authors and Affiliations

  1. Unit of Anatomic Pathology, Department of Surgery, Faculty of Medicine, 14004, Cordoba, Spain

    Antonio Lopez Beltran, Ana Blanca, Alfredo Vidal & Carlos Reymundo

  2. Champalimaud Foundation, Lisbon, Portugal

    Antonio Lopez Beltran, Ana Blanca, Alfredo Vidal & Carlos Reymundo

  3. Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

    Liang Cheng

  4. Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, Ancona, Italy

    Rodolfo Montironi

  5. Urology Service, Reina Sofia Hospital, Cordoba, Spain

    Manuel Leva

  6. Institut Universitaire de Cancérologie, GRC-05, ONCOTYPE-Uro, Université Paris 6, Paris, France

    Morgan Rouprêt

  7. Academic Department of Urology, Pitié-Salpétrière Hospital (Assistance Publique - Hôpitaux de Paris), Paris, France

    Morgan Rouprêt

  8. Urology Service, Champalimaud Foundation, Lisbon, Portugal

    Jorge Fonseca

  9. Pathology Service, Hospital de Cabueñes, Gijon, Spain

    Carmen L. Menendez

  10. Pathology Service, Hospital Arnau de Vilanova, Lleida, Spain

    Judit Pallares

  11. Pathological Anatomy, Pathology Service, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy

    Enrico Bollito

  12. UGC Anatomía Patológica, Complejo Hospitalario de Jaén, Jaén, Spain

    Rafael J Luque

  13. Academic Department of Pathology, Pitié-Salpétrière Hospital (Assistance Publique - Hôpitaux de Paris), Paris, France

    Eva Comperat

Authors
  1. Antonio Lopez Beltran
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  2. Liang Cheng
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  3. Rodolfo Montironi
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  4. Ana Blanca
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  5. Manuel Leva
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  6. Morgan Rouprêt
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  7. Jorge Fonseca
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  8. Alfredo Vidal
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  9. Carmen L. Menendez
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  10. Judit Pallares
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  11. Enrico Bollito
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  12. Carlos Reymundo
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  13. Rafael J Luque
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  14. Eva Comperat
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Correspondence to Antonio Lopez Beltran.

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Beltran, A.L., Cheng, L., Montironi, R. et al. Clinicopathological characteristics and outcome of nested carcinoma of the urinary bladder. Virchows Arch 465, 199–205 (2014). https://doi.org/10.1007/s00428-014-1601-y

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  • DOI: https://doi.org/10.1007/s00428-014-1601-y

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