Noninvasive papillary urothelial carcinoma with pathological features in between low and high grades: A case report.
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
30 Apr 2021
30 Apr 2021
Historique:
received:
04
02
2021
accepted:
08
04
2021
entrez:
28
4
2021
pubmed:
29
4
2021
medline:
7
5
2021
Statut:
ppublish
Résumé
Urinary bladder urothelial carcinoma is the most common malignant tumor in the urinary system, and noninvasive papillary urothelial carcinoma (NIPUC) comprises most bladder malignancies. NIPUC grading is important for therapeutic and clinical protocol selection. Here, we report a case of NIPUC with pathological features in between low (LG-NIPUC) and high (HG-NIPUC) grades NIPUC. A 72-year-old male, presenting with a 20-year history of hypertension and 5 months of hematuria. Computed tomography examination revealed a tumor in the urinary bladder neck. Microscopic investigation revealed that most tumor tissue samples had a branching papillary architecture, with well-developed fibrous-vascular cores. Tumor cells were slightly crowded, with somewhat altered cell polarity and cell adhesion. Immunohistochemistry showed positive Ki67 staining, mostly in the basal layer, while p53 staining was rarely positive. These samples were diagnosed as LG-NIPUC. However, a few tumor tissue samples presented mildly fused papillary architectures without cell polarity or adhesion. Most nuclei stained intensely and were pleomorphic. All epithelial tissue layers were ki67 positive, and the p53 positive rate was higher than that in the LG samples. Therefore, these were classified as HG-NIPUC. The tumor was completely resected during lithotomy postural surgery. The patient is alive with a good recovery during 3 months after the surgery. We diagnosed this patient as having LG-NIPUC with local HG-NIPUC components. HG- and LG-HIPUC have different outcomes. This case is a new challenge for the pathological grading of NIPUC. An intermediate HIPUC grade might need to be added to the original NIPUC grading system.
Identifiants
pubmed: 33907145
doi: 10.1097/MD.0000000000025693
pii: 00005792-202104300-00060
pmc: PMC8084004
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e25693Subventions
Organisme : National Natural Science Foundation of China
ID : 81602022
Organisme : Natural Science Foundation of Liaoning Province
ID : 2020-MS-142
Organisme : Nature Foundation Guidance Program of Liaoning Province
ID : 2019-ZD-0735
Organisme : 345 Talent Project of Shengjing Hospital of China Medical University
ID : 304050
Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interests to disclose.
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