Inverted urothelial papilloma

Cheville, John C.; Wu, Kevin J.; Sebo, Thomas J.; Liu, Cheng; Riehle, B S Darren; Lohse, Mariah; Pankratz, V. Shane

doi:10.1002/(sici)1097-0142(20000201)88:3<632::aid-cncr21>3.0.co;2-f

Cited by 46 publications

(7 citation statements)

References 32 publications

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“…Nonetheless, progression and recurrence rates for IUP have been demonstrated to be very low (<2% for both) [23–25], indicating that mutations in HRAS and/or FGFR3 alone are insufficient to cause UCA. The differences between IUP and UCA with regards to their expression of Ki-67 and p53 and UroVysion FISH support this concept [6, 26]. …”

Section: Discussionmentioning

confidence: 98%

HRAS mutations are frequent in inverted urothelial neoplasms

McDaniel¹,

Zhai²,

Cho³

et al. 2014

Human Pathology

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Inverted urothelial papilloma (IUP) is an uncommon neoplasm of the urinary bladder with distinct morphological features. Studies regarding the role of human papillomavirus (HPV) in the etiology of IUP have provided conflicting evidence of HPV infection. Additionally, little is known regarding the molecular alterations present in IUP or other urothelial neoplasms which might demonstrate inverted growth pattern like low-grade or high-grade urothelial carcinoma. Here, we evaluated for the presence of common driving somatic mutations and HPV within a cohort of inverted urothelial papillomas, (n=7) non-invasive low-grade papillary urothelial carcinomas with inverted growth pattern (n=5,) and non-invasive high-grade papillary urothelial carcinomas with inverted growth pattern (n=8). HPV was not detected in any case of inverted urothelial papilloma or inverted urothelial carcinoma by either ISH or by PCR. Next generation sequencing identified recurrent mutations in HRAS (Q61R) in 3 of 5 inverted urothelial papillomas, described for the first time in this neoplasm. Additional mutations of Ras pathway members were detected including HRAS, KRAS, and BRAF. The presence of Ras pathway member mutations at a relatively high rate suggests this pathway may contribute to pathogenesis of inverted urothelial neoplasms. Additionally, we did not find any evidence supporting a role for HPV in the etiology of inverted urothelial papilloma.

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Section: Discussionmentioning

confidence: 98%

HRAS mutations are frequent in inverted urothelial neoplasms

McDaniel¹,

Zhai²,

Cho³

et al. 2014

Human Pathology

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“…Similarly, Jones et al [ 1 ] described a steady increase in p53 expression in UC-IGP versus IP (59% vs. 7%) using a 1% cutoff, suggesting that p53 should be part of a multi-marker panel (along with Ki67 and CK20) to distinguish benign from malignant inverted lesions. Interestingly, there were no statistically significant differences in p53 protein staining between IPs in patients with and without a history of UC [ 36 ] and between IPs with and without atypia [ 37 ] in two previous studies ( Table 1 ). The use of different cutoffs can impair the reproducibility of immunohistochemical results among studies.…”

Section: Immunohistochemical Markersmentioning

confidence: 99%

“…Evidence from molecular genetic studies has shown that IPs have additional distinct molecular features compared to their malignant counterparts, such as low tumor mutational burden, mutations in the mitogen-activated protein kinase/ERK pathway, along with a lack of the prevalent APOBEC mutation signature [ 1 , 7 , 31 , 36 , 38 - 41 ]. On the other hand, both conventional UC and UC-IGP carry overlapping genetic alterations [ 53 ], namely mutations in FGFR3, TP53, CDKN1A, PIK3CA, FBXW7, ERBB2 , and NOTCH1 [ 18 , 40 ].…”

Section: Molecular Featuresmentioning

confidence: 99%

“…It has been suggested that most lesions diagnosed in the past as IP with concurrent UC were actually UC-IGPs [ 58 ], and some IPs were labeled as LG-UC-IGPs [ 59 ], resulting in confusion regarding the actual incidence of each disease. Moreover, a category of “IP with atypia” or “atypical IP” was introduced by some authors, referring to a subset of IP with malignant potential [ 36 , 37 ]. Compared to UC-IGP, IP with atypia has lower mitotic index and proliferative activity.…”

Section: Molecular Featuresmentioning

confidence: 99%

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Distinctive morphological and molecular features of urothelial carcinoma with an inverted growth pattern

Sanguedolce

Calò

Chirico

et al. 2021

J Pathol Transl Med

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Urothelial carcinoma with an inverted growth pattern (UC-IGP) is a peculiar entity within the spectrum of urothelial lesions. While efforts have been made over the last few decades to unravel its carcinogenesis and relationship with conventional urothelial carcinoma, the exact classification of inverted urothelial lesions is a matter of debate. The morphological features of UC-IGP pose several issues in differential diagnosis with other mostly benign lesions. Various techniques, including immunohistochemistry, UroVysion, and many molecular methods, have been employed to study the exact nature of this lesion. The aim of this review is to provide a comprehensive overview of the morphological and immunophenotypical aspects of UC-IGP. Moreover, we present and discuss the immunohistochemical and molecular markers involved in diagnosis and prognosis of UC-IGP lesions.

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“…12,13 Recent article and review shows that malignant tranformation is absent. 14–17 Some authors consider most atypical inverted papillomas previously described as urothelial carcinoma with inverted growth. 14–18 In this case report, we discuss the histological features and diagnostic challenges associated with urothelial carcinoma with abundant myxoid stroma in conjunction with a discussion regarding the appropriateness of the terminology and its coincidental simultaneous occurrence with inverted papilloma.…”

Section: Introductionmentioning

confidence: 99%

A Synchronous Occurrence of Urothelial Carcinoma with Abundant Myxoid Stroma and Inverted Papilloma of the Urinary Bladder

et al. 2012

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Abundant myxoid stroma rarely occurs in urothelial carcinomas, and may cause diagnostic challenges when cells with eosinophilic cytoplasm forming nests and cords in a myxoid background are seen, particularly in the absence of typical carcinomatous appearance. Microscopic examination of transurethral resection specimen of a 71-year-old male patient revealed non-cohesive oval or elongated tumor cells with eosinophilic cytoplasm arranged in cord-like filigree pattern in an abundant myxoid stroma. Immunohistochemically the tumor was positive for cytokeratin 7, cytokeratin 20, and 34BE12. About 90 to 100% nuclear staining was observed with p63, p53, and Ki-67. A second neoplasm with a flat overlying urothelial epithelium and a complete inverted cellular growth pattern was also noted. The neoplasm exhibited less than 2% and 10% nuclear staining with Ki-67 and p53, respectively. Considering histological, histochemical, and immunohistochemical findings, a diagnosis of synchronous urothelial carcinoma with abundant myxoid stroma and inverted papilloma was made.

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Inverted urothelial papilloma

Cited by 46 publications

References 32 publications

HRAS mutations are frequent in inverted urothelial neoplasms

HRAS mutations are frequent in inverted urothelial neoplasms

Distinctive morphological and molecular features of urothelial carcinoma with an inverted growth pattern

A Synchronous Occurrence of Urothelial Carcinoma with Abundant Myxoid Stroma and Inverted Papilloma of the Urinary Bladder

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