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Bladder
Urothelial carcinoma-invasive
Plasmacytoid carcinoma
Reviewer: Rugvedita Parakh, Cedars-Sinai Medical Center, Los Angeles, California
Revised: 6 June 2010, last major update June 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Urothelial carcinoma in which tumor cells have features of plasma cells, due to abundant glassy eosinophilic cytoplasm and eccentric nuclei
Clinical features
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● Rare
● Tends to present at advanced stage with poor prognosis (Am J Surg Pathol 2008;32:752)
● May spread in abdominal cavity more commonly than other variants
Case reports
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● 57 year old man with metastatic disease (Cases J 2009 Apr 28;2:6647)
Micro description
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● Urothelial tumor cells resemble plasma cells, due to abundant glassy eosinophilic cytoplasm and eccentric nuclei
● Myxoid or loose edematous stroma
● Retraction spaces around tumor cells
● Classic urothelial carcinoma usually also present
Micro description
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H&E CK7
H&E Keratin+ Keratin+ nodal metastasis
Fig A: Diffuse infiltration
Fig B: Malignant cells with eosinophilic cytoplasm and eccentric nuclei
Fig C: Resembling signet-ring cells
Fig D: AE1/AE3 positive (strong)
Cytology description
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● Scattered dyscohesive cells with a plasmacytoid appearance characterized by abundant cytoplasm, eccentric nuclei and inconspicuous nucleoli (Diagn Cytopathol 2009;37:359)
Positive stains
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● Cytokeratin (strong)
● May be CD138+ (Hum Pathol 2009;40:1023, Am J Surg Pathol 2009;33:417)
Negative stains
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● Plasma cell and lymphocyte markers, gamma globulin, light chains
Differential Diagnosis
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● Plasmacytoma: often associated with myeloma, no usual type urothelial carcinoma, tumor cells have plasmacytic features, are keratin-
Additional references
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End of Bladder > Urothelial carcinoma-invasive > Plasmacytoid carcinoma
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