Home Chapter Home Jobs Conferences Fellowships Books
Advertisement
Bladder
Other Carcinomas
Adenocarcinoma – in situ
Author: Nat Pernick, M.D. (see Authors page)
Revised: 22 December 2009, UPDATE IN PROGRESS
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Definition
=========================================================================
● Rare lesion found alone or with invasive adenocarcinoma
Terminology
=========================================================================
Epidemiology
=========================================================================
Sites
=========================================================================
Etiology
=========================================================================
● Associated with cystitis glandularis; may also be due to urachus (Am J Surg Pathol 2002;26:271)
Clinical features
=========================================================================
●
Prognostic factors
=========================================================================
Case reports
=========================================================================
Treatment
=========================================================================
Clinical images
=========================================================================
● Findings below are for patients without concurrent invasive adenocarcinoma or villous adenoma:
● Mean age 70 years, 79% male
● Associated with urothelial CIS or papillary urothelial carcinoma without invasion
● 74% had or developed invasive carcinoma, including high incidence of micropapillary and small cell urothelial carcinomas (AJSP 2001;25:892)
Gross description (Macroscopy)
=========================================================================
Gross images
=========================================================================
Micro description (Histopathology)
=========================================================================
● Papillary (J Urol 1985;134:544), flat and cribriform architecture with atypical columnar epithelium, often with apical cytoplasm
● True glandular differentiation (by definition)
● Moderate to severe nuclear pleomorphism, apoptosis, 5+ mitotic figures/10 HPF
● Noninvasive (by definition), using analogous criteria for invasion in GI tract (noninvasive glands lack a desmoplastic or associated inflammatory stromal reaction; base of lesion is parallel to basement membrane of adjacent uninvolved mucosa; no single cells or isolated poorly formed glands)
● Some authors require derivation from glandular cells (cystitis glandularis)
● Associated with villous adenoma (Hum Pathol 2002;33:236) and invasive urothelial carcinoma, particularly micropapillary and small cell types
Micro images
=========================================================================
Villous adenoma with anaplasia bordering on carcinoma in situ #1; #2
Cytology description
=========================================================================
●
Cytology images
=========================================================================
●
Positive stains
=========================================================================
● Variable P501S (prostein) and PSMA (prostate specific membrane antigen, Am J Surg Pathol 2008;32:1322)
Negative stains
=========================================================================
●
Electron microscopy descriptions
=========================================================================
●
Electron microscopy images
=========================================================================
Molecular / cytogenetics description
=========================================================================
●
Molecular / cytogenetics images
=========================================================================
Differential Diagnosis
=========================================================================
● Noninvasive urothelial carcinoma with glandular differentiation (Am J Surg Pathol 2009;33:1241, Mod Pathol 2009;22:1280)
● Urothelial carcinoma with gland-like lumina: has small cystic spaces containing mucin, not lined by columnar epithelium
Additional references
=========================================================================
●
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 also 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)..