Relationship of Cytokeratin 20 and CD44 Protein Expression with WHO/ISUP Grade in pTa and pT1 Papillary Urothelial Neoplasia

Desai, Sangeeta; Lim, So Dug; Jimenez, Rafael E.; Chun, Thomas Y.; Keane, Thomas E.; McKenney, Jesse K.; Zavala-Pompa, Ángel; Cohen, Cynthia; Young, Robert H.; Amin, Mahul B.

doi:10.1038/modpathol.3880241

Cited by 133 publications

(117 citation statements)

References 43 publications

(43 reference statements)

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“…Very limited studies have investigated the immunohistochemical profile of urothelial papillomas; cytokeratin 20 (CK20) has been analyzed in two studies (8,9), and standard isoform CD44 antibodies in one study (8). The findings corroborate the morphologic observation of normal-appearing urothelium on a fibrovascular stalk.…”

Section: Table 2 Summary Of Clinicopathologic Data Of Patients With supporting

confidence: 62%

“…The staining pattern with CK20 in urothelial papillomas in most cases is similar to that seen in normal urothelium (i.e., CK20 immunoreactivity is restricted to the umbrella cell layer with an absence of staining in the basal and intermediate cells) (8,9). CD44 expression in urothelial papillomas, like normal urothelium, is limited to the basal cell layer (8). In contrast, papillary urothelial neoplasms of low malignant potential and low-grade papillary transi- tional cell carcinomas show higher rates of CK20 and CD44 overexpression (8).…”

Section: Table 2 Summary Of Clinicopathologic Data Of Patients With mentioning

confidence: 66%

“…The findings corroborate the morphologic observation of normal-appearing urothelium on a fibrovascular stalk. The staining pattern with CK20 in urothelial papillomas in most cases is similar to that seen in normal urothelium (i.e., CK20 immunoreactivity is restricted to the umbrella cell layer with an absence of staining in the basal and intermediate cells) (8,9). CD44 expression in urothelial papillomas, like normal urothelium, is limited to the basal cell layer (8).…”

Section: Table 2 Summary Of Clinicopathologic Data Of Patients With mentioning

confidence: 68%

“…CD44 expression in urothelial papillomas, like normal urothelium, is limited to the basal cell layer (8). In contrast, papillary urothelial neoplasms of low malignant potential and low-grade papillary transi- tional cell carcinomas show higher rates of CK20 and CD44 overexpression (8). In our opinion, however, immunohistochemistry plays no role in the diagnosis of urothelial papillomas, which is essentially based on light microscopy using architectural and cytologic features.…”

Section: Table 2 Summary Of Clinicopathologic Data Of Patients With mentioning

confidence: 69%

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Urothelial (Transitional Cell) Papilloma of the Urinary Bladder: A Clinicopathologic Study of 26 Cases

2003

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The existence of a papillary lesion of the urinary bladder with a benign clinical course and recognizable morphologic features that merit the benign categorization "papilloma" has been controversial. The clinical aspects and histologic features of these lesions remain to be fully elucidated. We have studied the clinicopathologic features of 26 patients with urothelial papillomas and correlated them with outcome. Papillomas occurred in two distinct clinical settings: (1) de novo neoplasms (23/26) or (2) those occurring in patients with a known clinical history of bladder cancer ("secondary" papillomas; 3/26). Follow-up information was available in 14/23 of the de novo cases (mean ‫؍‬ 39 mo) and in 3/3 secondary cases (mean ‫؍‬ 24 mo). Patients with de novo papillomas had a mean age of 46 years; 16 were male and 7 were female. Twelve of 14 had a benign clinical course with no recurrences; 1 developed a recurrent papilloma at 3 years, and 1 developed a pT3a high-grade papillary urothelial carcinoma at 4 years. Patients with secondary papillomas had a mean age of 66 years; two were male and one was a female. One of these patients developed two additional recurrences, and two patients had no new recurrences. Morphologically, the papillary architecture ranged from a common simple, nonhierarchical arrangement to, infrequently, more complex anastomosing papillae with budding. The individual papillae ranged from small (most common), with scant stroma and slender fibrovascular cores, to large, with marked stromal edema and/or cystitis cystica-like urothelial invaginations. Common to all was a lining of normal-appearing urothelium without hyperplasia, maintenance of normal polarity, and frequent prominence of the umbrella cell layer. Overall, no patient with a diagnosis of papilloma died of disease; only one patient with a de novo lesion (7.0%) had a recurrent papilloma, and 1/14 (7.0%) progressed to a higher grade and stage of disease, although this patient was on immunosuppressive therapy secondary to a renal transplant. De novo urothelial papillomas occur in younger patients and usually have a benign course. Urothelial papillomas are histologically and probably biologically distinctive tumors and merit distinction from other higher risk papillary neoplasms of the urinary bladder.

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Section: Table 2 Summary Of Clinicopathologic Data Of Patients With supporting

confidence: 62%

Section: Table 2 Summary Of Clinicopathologic Data Of Patients With mentioning

confidence: 66%

Section: Table 2 Summary Of Clinicopathologic Data Of Patients With mentioning

confidence: 68%

Section: Table 2 Summary Of Clinicopathologic Data Of Patients With mentioning

confidence: 69%

See 2 more Smart Citations

Urothelial (Transitional Cell) Papilloma of the Urinary Bladder: A Clinicopathologic Study of 26 Cases

2003

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“…No statistical significant difference was detected; possibly due to the small number of cases showing normal expression. Desai et al 24 found that tumors with normal CK20 expression recurred less frequently than tumors with abnormal pattern, but with insignificant statistical difference (44.9% vs. 63.2%, p = 0.06). However, Harnden et al 25 revealed that disruption of normal CK20 expression was highly significantly correlated with recurrent tumors.…”

Section: Discussionmentioning

confidence: 99%