Home   Chapter Home   Jobs   Conferences   Fellowships   Books



Advertisement

Bladder

Other Carcinomas

Adenocarcinoma - in situ


Reviewers: Rugvedita Parakh, M.D., HCG Oncology (see Reviewers page)
Revised: 6 June 2011, last major update June 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Definition
=========================================================================

● Primary noninvasive adenocarcinoma of bladder
● Findings below are for patients without concurrent invasive adenocarcinoma or villous adenoma

Terminology
=========================================================================

● Also called noninvasive urothelial carcinoma with glandular differentiation (Am J Surg Pathol 2009;33:1241)

Clinical features
=========================================================================

● Mean age 70 years, 75% male
● Associated with urothelial CIS or papillary urothelial carcinoma without invasion
● 50-74% developed invasive carcinoma, including high incidence of poorly differentiated, micropapillary and small cell urothelial carcinoma (Am J Surg Pathol 2001;25:892)

Treatment
=========================================================================

● Transurethral excision; intravesical chemotherapy; intravesical bCG

Gross description
=========================================================================

● Exophytic, papillary to flat

Micro description
=========================================================================

● Papillary, flat, and cribriform architecture
● Neoplastic cells are columnar with luminal cytoplasm with occasional intracytoplasmic mucin
● True glandular differentiation (by definition)
● Moderate to severe nuclear pleomorphism, apoptosis, 5+ mitotic figures/10 HPF
● Noninvasive, by definition
● Often associated with other urothelial carcinoma patterns including small cell, micropapillary and poorly differentiated
● Rare necrosis
● Not commonly associated with invasive adenocarcinoma

Micro images
=========================================================================


   
Villous adenoma with marked atypia

Differential diagnosis
=========================================================================

Urothelial carcinoma in situ: no invasion, no glandular formation, no/rare intracytoplasmic mucin
Urothelial carcinoma with gland like spaces: invasive, no true glandular formation, no/rare intracytoplasmic mucin
Florid cystitis glandularis with or without intestinal metaplasia: insufficient atypia to diagnosis as carcinoma in situ
Villous adenoma: insufficient atypia to diagnosis as carcinoma in situ
Noninvasive micropapillary carcinoma: has characteristic retraction-like spaces; no glandular formation, no/rare intracytoplasmic mucin
Clear cell adenocarcinoma: invasive, hobnail cells

End of Bladder > Other Carcinomas > Adenocarcinoma in situ


This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).