Endocrine differentiation in inflamed urinary bladder epithelium with metaplastic changes

Carcinoid tumor associated with adjacent dysplastic columnar epithelium in the renal pelvis: A case report and literature review

Carcinoid tumors are well documented in the pulmonary and gastrointestinal systems, but very rare in the urinary tract, especially in the renal pelvis. We report on a 60-year-old female patient who presented with left flank pain and fever. Abdominal computed tomography demonstrated a heterogeneously enhancing mass in the left renal pelvis and a stone at the left proximal ureter. Multiple parenchymal lesions were also observed, which were identified as uneven caliectasis displaying air-fluid levels and renal parenchymal atrophy. The patient underwent simple nephro-ureterectomy. Macroscopically, a polypoid mass was observed in the renal pelvis. Microscopically, the tumor revealed acinar, tubular, and solid pattern and was composed of small, monotonous and hyperchromatic cells. Lining epithelia in renal pelvis and ureter revealed columnar epithelia with dysplastic change. The tumor cells were positive for chromogranin A, synaptophysin, CD56, and focally positive for cytokeratin. Immunohistochemical staining of synaptophysin and chromogranin A highlighted the neuroendocrine cells in the columnar epithelium. Ki-67 (1:50; MIB-1) labeling index was less than 1% in the area with highest uptake. We report here a case of carcinoid tumor of the renal pelvis that was associated with adjacent dysplastic columnar epithelium.

Primary carcinoid tumor of the urinary bladder with prominent subnuclear eosinophilic granules

Primary carcinoid tumor of the urinary bladder is a very rare neoplasm. We report here a case of primary carcinoid tumor of the urinary bladder with an unusual cytological feature in a 72-year-old Japanese man. A bladder polypoid mass was incidentally found by ultrasonography during the follow-up of a benign prostate hyperplasia. Histological examination of the transurethrally resected tissue revealed that the upper part of the mass was a tumor showing tubuloglandular anastomosing structures. Most of the tumor cells had peculiar subnuclear eosinophilic granules. The features of the granules were reminiscent of those observed in neuroendocrine cells of the intestine. The tumor cells were immunohistochemically positive for chromogranin A and synaptophysin. The tumor was diagnosed as carcinoid tumor of pure form of the urinary bladder. The lower part of the mass showed the findings of glandular cystitis, as its coexistence with carcinoid tumors of the bladder has often been described in previous reports.

Interstitial cystitis in cats

Despite much research on FUS, there still is no consensus regarding its cause, or even its definition. We recently have demonstrated that some cases of FUS are similar to interstitial cystitis in human beings. Exclusion of anatomic defects, behavior abnormalities, neoplasia, urolithiasis, urethral obstruction, and urinary tract infection leads one to the diagnosis of interstitial cystitis in cats. This diagnosis suggests the need for new approaches to treatment, including pain management and environmental modification.

Neurotensin is localized to paracrine cells in the urinary bladder of the turtle, Chrysemys picta

Urinary bladder from the painted turtle, Chrysemys picta, contains a substantial population of endocrine/paracrine cells scattered through the mucosal epithelium which immunostains using antisera directed toward mammalian neurotensin (NT). Radiommunoassay of 0.1 N HCl extracts of Chrysemys bladder indicated an immunoreactive NT (iNT) concentration of 161 +/- 39 pmol/g tissue (n = 9), an amount lower but comparable in magnitude to that found in mucosal scrapings of the intestine (926 +/- 125 pmol/g, n = 9). Bladder and intestinal iNT were indistinguishable during chromatography on Sephadex G-25 and HPLC on mu-Bondapak C18 where they eluted at the same position as avian NT. Similar results were obtained by immunocytochemistry and radioimmunoassay of urinary bladders from Pseudemys scripta scripta, P. scripta elegans, and P. floridana, three emydid species closely related to C. picta, but not from Sternotherus odoratus and Trionyx spinifer asper, representatives of the families Kinosternidae and Trionychidae, respectively, although positive results were obtained with intestinal preparations from these species. NT cells were not seen in urinary bladder from Rana pipiens, Bufo marinus, Necturus maculosus, or Anolis carolinensis. Thus, the presence of NT-containing cells in urinary bladder is not common among subavian vertebrates and may even be restricted to the Emydidae family of chelonians.

Argyrophilic and hormone immunoreactive cells in normal and hyperplastic pancreatic ducts and exocrine pancreatic carcinoma

Scattered argyrophil cells were present in normal, large, medium-sized and small pancreatic ducts (ductules). There was marked increase in argyrophil cells in ducts with hyperplastic epithelium. Argyrophil cells were also found in 67.7% of all exocrine pancreatic carcinomas. In a well differentiated group including cystadenocarcinoma, mucinous carcinoma and well differentiated ductal adenocarcinoma argyrophil cells were found in all cases examined. Using four antisera (against insulin, glucagon, somatostatin and gastrin), insulin, glucagon and somatostatin cells were identified in 2.65%, 0.001% and 1.2% of normal ducts, and 7.5%, 2.4% and 4.6% of ducts with hyperplastic epithelium respectively and were also greatly increased in numbers in the latter group. Immunoreactive cells were present in 66.7% of exocrine carcinomas. Cells reactive for insulin were found in 7/15 cases; glucagon in 6/15 cases; somatostatin in 5/15 cases and gastrin in 2/15 cases. Eight cases contained two or more than two types of immunoreactive cells. The presence of argyrophil and hormone immunoreactive cells in pancreatic ducts and carcinomas is indicative of the close developmental relationship between endocrine and exocrine parts of the pancreas. The inter-relationship of response in the different cell types following stimulus suggests that injury to a common precursor may be involved.