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 Treatment
● Transurethral excision; intravesical chemotherapy; intravesical bCG Gross description
● Exophytic, papillary to flat Micro description
● Papillary, flat, and cribriform architecture Micro images Differential diagnosis
● Urothelial carcinoma in situ: no invasion, no glandular formation, no/rare intracytoplasmic mucin
End of Bladder > Other Carcinomas > Adenocarcinoma in situ
● 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)
=========================================================================
=========================================================================
=========================================================================
● 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
=========================================================================
Villous adenoma with marked atypia
=========================================================================
● 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
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).