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Urothelial carcinoma-invasive

Undifferentiated carcinoma

Reviewer: Rugvedita Parakh, M.D. (see Reviewers page)
Revised: 9 February 2013, last major update June 2010
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.


● Rare poorly differentiated pleomorphic carcinoma that cannot be otherwise classified
● ICD-O: 8020/3


● Includes large cell undifferentiated carcinoma, but large cell neuroendocrine carcinoma, osteoclast-rich urothelial carcinoma and small cell carcinoma are described separately

Clinical features

● 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

● 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

● AE1/AE3 and CK7; variable CAM 5.2, CK20, thrombomodulin and uroplakin III
● High Ki-67, p53+

Negative stains

● AFP, beta hCG, PSA, vimentin, synaptophysin and chromogranin

Differential diagnosis

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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