Secondary neoplasms of the bladder are histological mimics of nontransitional cell primary tumours: clinicopathological and histological features of 282 cases

Bates, Alan; Baithun, Suhail

doi:10.1046/j.1365-2559.2000.00797.x

Cited by 195 publications

(169 citation statements)

References 39 publications

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“…Previous studies have suggested a close histogenetic and pathogenetic relationship of primary adenocarcinoma of the urinary bladder and colorectal adenocarcinoma. [22][23][24][25][26] Our finding that cadherin-17 and GATA3 expression are very similar in these two tumor types supports this relationship (Table 2). However, positive nuclear and cytoplasmic immunostaining for b-catenin was evident in 95% of (21/ 22) primary and 92% of (23/25) secondary colorectal adenocarcinoma, in contrast to positive membranous and cytoplasmic staining for b-catenin in 92% of (23/25) primary adenocarcinomas of the urinary bladder and 100% of (11/11) urothelial carcinomas with glandular differentiation (Po0.001).…”

Section: Discussionsupporting

confidence: 74%

Distinguishing primary adenocarcinoma of the urinary bladder from secondary involvement by colorectal adenocarcinoma: extended immunohistochemical profiles emphasizing novel markers

et al. 2013

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Glandular neoplasms involving the urinary bladder carry a challenging differential diagnosis including primary and secondary processes. We investigated the potential diagnostic utility of cadherin-17 and GATA3 in 25 primary adenocarcinomas of the urinary bladder, as compared with other commonly used markers including b-catenin and p63. Urothelial carcinoma with glandular differentiation (11), colorectal adenocarcinoma secondarily involving the bladder (25), and primary colorectal adenocarcinoma (22) were also analyzed and the results were compared using a Fisher exact test. Cadherin-17 was expressed in 23/25 primary bladder adenocarcinomas (92%), 23/25 colorectal adenocarcinomas involving the bladder (92%), 21/22 primary colorectal adenocarcinomas (95%) and entirely negative (0/11) in both components of urothelial carcinoma with glandular differentiation (Po0.001). In urothelial carcinoma with glandular differentiation, positive nuclear staining for GATA3 was evident in the urothelial component for 18% (2/11) and the glandular component for 9% (1/11) with additional tumors showing only cytoplasmic staining. Nuclear reactivity for GATA3 was not present in primary bladder adenocarcinoma and primary/secondary colorectal adenocarcinoma (Po0.05). Positive nuclear and cytoplasmic immunostaining for b-catenin was evident in 21/22 primary colorectal adenocarcinomas (95%) and 23/25 cases of secondary involvement by colorectal adenocarcinoma (92%). In contrast, positive membranous and cytoplasmic staining for b-catenin was observed in 23/25 primary bladder adenocarcinomas (92%) and 11/11 urothelial carcinomas with glandular differentiation (100%, Po0.001). p63 was expressed only in the urothelial component of urothelial carcinoma with glandular differentiation and not in the glandular component (Po0.001). In summary, cadherin-17 is a relatively specific and sensitive marker for primary adenocarcinoma of the urinary bladder, distinguishing it from urothelial carcinoma with glandular differentiation. However, it does not distinguish primary bladder adenocarcinoma from secondary involvement by colorectal adenocarcinoma. The pattern of reactivity for b-catenin remains the most useful marker for distinguishing these two tumors.

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Section: Discussionsupporting

confidence: 74%

Distinguishing primary adenocarcinoma of the urinary bladder from secondary involvement by colorectal adenocarcinoma: extended immunohistochemical profiles emphasizing novel markers

et al. 2013

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“…78 Urinary bladder invasion by prostatic carcinoma can also occur via lymphovascular invasion, without contiguous spread. 83 Results of ISUP survey and consensus meeting on pT4 disease A consensus in the survey considered direct rectal involvement by prostatic carcinoma to be pT4; 4% of the respondents to the survey would not stage the tumor and 1% would classify rectal involvement as M1 (Table 1).…”

Section: Results Of Isup Survey and Consensus Meeting On Lymphovasculmentioning

confidence: 99%

International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 3: extraprostatic extension, lymphovascular invasion and locally advanced disease

et al. 2011

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made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to extraprostatic extension (pT3a disease), bladder neck invasion, lymphovascular invasion and the definition of pT4 were coordinated by working group 3. It was agreed that prostate cancer can be categorized as pT3a in the absence of adipose tissue involvement when cancer bulges beyond the contour of the gland or beyond the condensed smooth muscle of the prostate at posterior and posterolateral sites. Extraprostatic extension can also be identified anteriorly. It was agreed that the location of extraprostatic extension should be reported. Although there was consensus that the amount of extraprostatic extension should be quantitated, there was no agreement as to which method of quantitation should be employed. There was overwhelming consensus that microscopic urinary bladder neck invasion by carcinoma should be reported as stage pT3a and that lymphovascular invasion by carcinoma should be reported. It is recommended that these elements are considered in the development of practice guidelines and in the daily practice of urological surgical pathology.

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“…1 The distinction between primary and secondary adenocarcinomas of the bladder is important to clinical management, but may not always be straightforward to pathologists or clinicians. This is particularly true when the secondary adenocarcinoma is of colorectal origin, which may exhibit histologic features similar to or indistinguishable from primary bladder adenocarcinoma.…”

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Value of CDX2, villin, and α-methylacyl coenzyme A racemase immunostains in the distinction between primary adenocarcinoma of the bladder and secondary colorectal adenocarcinoma

et al. 2005

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Primary adenocarcinoma of the urinary bladder is an uncommon neoplasm that can be indistinguishable morphologically from colorectal adenocarcinoma secondarily involving the bladder by direct extension or metastasis. In the current study, 17 enteric-type primary adenocarcinomas of the bladder were immunohistochemically examined for the expression of CDX2, villin and a-methylacyl coenzyme A racemase (AMACR), immunomarkers preferentially expressed in colorectal adenocarcinoma. For comparison, 17 secondary colorectal adenocarcinomas involving the bladder, 23 primary colorectal adenocarcinomas and 14 conventional urothelial carcinomas were similarly studied. The results show that all 40 (100%) colorectal adenocarcinomas expressed CDX2 and 39 (98%) expressed villin. The expression of these two immunomarkers was less frequent in primary bladder adenocarcinomas, observed in eight (47%) and 11 (65%) cases, respectively (Po0.0001 and P ¼ 0.0019, respectively). The frequency of positive AMACR immunostaining was similar between these two types of tumors, detected in 28 (70%) colorectal adenocarcinomas and 11 (65%) primary bladder adenocarcinomas (P ¼ 0.694). None of the urothelial carcinomas exhibited CDX2 or villin immunoreactivity; and only two (14%) showed positive staining for AMACR. These results demonstrate that CDX2 and villin are of diagnostic value in aiding in the distinction between primary adenocarcinoma of the bladder and secondary colorectal carcinoma. Lack of CDX2 and villin signals points strongly to a bladder primary.

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Secondary neoplasms of the bladder are histological mimics of nontransitional cell primary tumours: clinicopathological and histological features of 282 cases

Abstract: The incidence of secondary bladder tumours is comparable to that of nontransitional cell primary tumours. Few secondary tumours have distinctive histological features, hence knowledge of the history and clinical investigations are particularly important in their diagnosis.

Cited by 195 publications

References 39 publications

Distinguishing primary adenocarcinoma of the urinary bladder from secondary involvement by colorectal adenocarcinoma: extended immunohistochemical profiles emphasizing novel markers

Distinguishing primary adenocarcinoma of the urinary bladder from secondary involvement by colorectal adenocarcinoma: extended immunohistochemical profiles emphasizing novel markers

International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 3: extraprostatic extension, lymphovascular invasion and locally advanced disease

Value of CDX2, villin, and α-methylacyl coenzyme A racemase immunostains in the distinction between primary adenocarcinoma of the bladder and secondary colorectal adenocarcinoma

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