Bladder & ureters
Urothelial carcinoma - invasive
Plasmacytoid variant

Topic Completed: 1 December 2014

Minor changes: 3 April 2020

Copyright: 2003-2020,, Inc.

PubMed Search: Plasmacytoid variant urothelial carcinoma

Rugvedita Parakh, M.D.
Page views in 2019: 2,336
Page views in 2020 to date: 993
Cite this page: Parakh R. Plasmacytoid variant of urothelial carcinoma. website. Accessed May 28th, 2020.
Definition / general
  • Urothelial carcinoma in which tumor cells have features of plasma cells, due to abundant glassy eosinophilic cytoplasm, eccentric nuclei and indistinct nucleoli
  • Included in the WHO classification since 2004
Clinical features
  • Rare
  • Tends to present at advanced stage with poor prognosis
  • Diagnosed at advanced pathological stage (64% pT3, 23% pT4), showing metastases in 60% (Int J Cancer 2011;129:346)
  • May spread in abdominal cavity more commonly than other variants
Case reports
Microscopic (histologic) description
  • Urothelial tumor cells resemble plasma cells, due to abundant glassy eosinophilic cytoplasm and eccentric nuclei
  • Discohesive single cell pattern resembling lobular breast carcinoma or diffuse type of gastric cancer
  • Myxoid or loose edematous stroma
  • Retraction spaces around tumor cells
  • Classic urothelial carcinoma usually also present
Microscopic (histologic) images

Case of the Month #219






Cytology description
  • Scattered discohesive cells with a plasmacytoid appearance, characterized by abundant cytoplasm, eccentric nuclei and inconspicuous nucleoli (Diagn Cytopathol 2009;37:359)
Positive stains
Negative stains
  • Plasma cell and lymphocyte markers, gamma globulin, light chains
  • Membranous E-cadherin (usually)
Molecular / cytogenetics description
  • Highly aneuploid and polysomic
  • Deletion on chromosome 9p21 is common
  • p53 mutation in 29%
Differential diagnosis
  • Plasmacytoma: often associated with myeloma, no usual type urothelial carcinoma, tumor cells have plasmacytic features, are keratin-
  • Metastatic lobular breast carcinoma: ER/PR positive, GCDFP 15 or mammoglobin positive, always E-cadherin negative, no usual type urothelial carcinoma
Additional references
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