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Bladder

Urothelial carcinoma

Endophytic growth pattern

 

Reviewer: Rugvedita Parakh, Cedars-Sinai Medical Center, Las Angeles, California

Revised: 3 June 2010, last major update June 2010

Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.

 

Definition

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● Endophytic growth pattern can be associated with papilloma, urothelial neoplasm of low malignant potential, low / high grade tumors that are noninvasive or invasive; this topic discusses invasive tumors

● Anastomosing cords and columns of urothelium resembling inverted papilloma or broad pushing bulbous invaginations into lamina propria (broad front pattern), but with definitive evidence of invasion

● Not a WHO diagnosis

 

Epidemiology

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● Mean age 68 years

● 75% male

 

Clinical

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● Pattern present in 11% of urothelial carcinomas

● Associated with high grade and high stage tumors, and possibly poorer prognosis (Urol Oncol 2010 Mar 5 [Epub ahead of print])

 

Micro description

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● Anastomosing cords and columns of urothelium resembling inverted papilloma or broad pushing bulbous invaginations into lamina propria (broad front pattern)

● Invasive if there is irregularity of broad front of bulbous invaginations, retraction artifact, desmoplasia or other features of destructive invasion

● Usually exophytic papillary urothelial carcinoma is also present

● Pattern is associated with invasion in 50% of papillary urothelial carcinomas (Am J Surg Pathol 1997;21:1057)

 

Micro images

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Figure 6 - Unfortunately we are unable to provide accessible alternative text for this. If you require assistance to access this image, please contact help@nature.com or the author

Non-invasive and invasive

 

Additional references

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● Inverted papilloma: may have focal papillary pattern; normal bland urothelium with occasional umbrella cells, no invasion (Ann Diagn Pathol 2009;13:158); negative for Ki-67, CK20, p53, normal FISH (Am J Surg Pathol 2007;31:1861)

 

End of Bladder > Urothelial carcinoma > Endophytic growth pattern

 

 

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