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Bladder
Urothelial carcinoma-invasive
Undifferentiated carcinoma
Reviewer: Rugvedita Parakh, Cedars-Sinai Medical Center, Las Angeles, California
Revised: 12 June 2010, last major update June 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Rare poorly differentiated pleomorphic carcinoma that cannot be otherwise classified
● ICD-O: 8020/3
Terminology
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● Includes large cell undifferentiated carcinoma, but giant cell carcinoma, large cell neuroendocrine carcinoma, osteoclast-rich urothelial carcinoma and small cell carcinoma are described separately
Clinical features
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● Very rare if exclude other undifferentiated carcinomas with distinct histologic features indicated above
● Advanced stage at presentation with nodal metastases
● Poorer survival than urothelial carcinoma NOS of similar stage (Pathology 2010;42:364)
Micro description (Histopathology)
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● Sheets of usually large polygonal or round cells with moderate to abundant cytoplasm, distinct cell borders
● Usually 90%+ of tumor is composed of large cell component
● Tumor is either infiltrative or has solid expansile nests with variable dyscohesive growth
● By definition, no features of other histologic types are present
Positive stains
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● AE1/AE3 and CK7; variable CAM 5.2, CK20, thrombomodulin and uroplakin III
● High Ki-67, p53+
Negative stains
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● AFP, beta hCG, PSA, vimentin, synaptophysin and chromogranin
Differential Diagnosis
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● Lymphoma: morphology of lymphoma subtype, negative for keratin, positive for lymphocytic markers
● Melanoma: spindled or epithelioid; prominent nucleoli; positive for melanocytic markers
End of Bladder > Urothelial carcinoma-invasive > Undifferentiated carcinoma
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