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Yoshimura K, Ito Y, Suzuki M, Horie M, Nishiuchi T, Shintani-Domoto Y, Shigehara K, Oshima H, Oshima M, Goto A, Nojima T, Tsuzuki T, Mizokami A, Ikeda H, Maeda D. Identification of uromodulin deposition in the stroma of perinephric fibromyxoid nephrogenic adenoma by mass spectrometry. Pathol Int 2024; 74:187-196. [PMID: 38289139 DOI: 10.1111/pin.13409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/09/2024] [Accepted: 01/13/2024] [Indexed: 02/03/2024]
Abstract
Nephrogenic adenoma (NA) is an epithelial lesion that usually occurs in the mucosa of the urinary tract. Rare cases of deep infiltrative or perinephric lesions have also been reported. Recently, NA with characteristic fibromyxoid stroma (fibromyxoid NA) has been proposed as a distinct variant. Although shedding of distal renal tubular cells due to urinary tract rupture has been postulated as the cause of NA in general, the mechanism underlying extraurinary presentation of NA and fibromyxoid stromal change in fibromyxoid NA remains unknown. In this study, we performed mass spectrometry (MS) analysis in a case of perinephric fibromyxoid NA of an 82-year-old man who underwent right nephroureterectomy for distal ureteral cancer. The patient had no prior history of urinary tract injury or radiation. Periodic acid-Schiff staining-positive eosinophilic structureless deposits in the stroma of fibromyxoid NA were microdissected and subjected to liquid chromatography/MS. The analysis revealed the presence of a substantial amount of uromodulin (Tamm-Horsfall protein). The presence of urinary content in the stroma of perinephric fibromyxoid NA suggests that urinary tract rupture and engraftment of renal tubular epithelial cells directly cause the lesion.
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Affiliation(s)
- Kaori Yoshimura
- Department of Pathology, Kanazawa University Hospital, Kanazawa, Japan
| | - Yukinobu Ito
- Department of Molecular and Cellular Pathology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Mina Suzuki
- Department of Molecular and Cellular Pathology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Masafumi Horie
- Department of Molecular and Cellular Pathology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Takumi Nishiuchi
- Division of Integrated Omics Research, Bioscience Core Facility, Research Canter for Experimental Modelling of Human Disease, Kanazawa University, Kanazawa, Japan
| | | | - Kazuyoshi Shigehara
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Hiroko Oshima
- Division of Genetics, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Masanobu Oshima
- Division of Genetics, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Akiteru Goto
- Department of Cellular and Organ Pathology, Graduate School of Medicine, Akita University, Akita, Japan
| | - Takayuki Nojima
- Department of Pathology, Kanazawa University Hospital, Kanazawa, Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, School of Medicine, Aichi Medical University, Nagoya, Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Hiroko Ikeda
- Department of Pathology, Kanazawa University Hospital, Kanazawa, Japan
| | - Daichi Maeda
- Department of Molecular and Cellular Pathology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
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Kobayashi G, Uraoka N, Sentani K, Shibata J, Nobuhiro R, Saito Y, Taniyama D, Hanamoto M, Nose H, Oue N. Cytological and histological findings of upper tract mucinous urothelial carcinoma with clear cell component: A case report and review of literature. Diagn Cytopathol 2021; 50:E129-E135. [DOI: 10.1002/dc.24921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/02/2021] [Accepted: 12/15/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Go Kobayashi
- Department of Pathology, Kure‐Kyosai Hospital Federation of National Public Service Personnel Mutual Aid Associations Hiroshima Japan
| | - Naohiro Uraoka
- Department of Pathology, Kure‐Kyosai Hospital Federation of National Public Service Personnel Mutual Aid Associations Hiroshima Japan
| | - Kazuhiro Sentani
- Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Jun Shibata
- Department of Pathology, Kure‐Kyosai Hospital Federation of National Public Service Personnel Mutual Aid Associations Hiroshima Japan
| | - Ryosuke Nobuhiro
- Department of Pathology, Kure‐Kyosai Hospital Federation of National Public Service Personnel Mutual Aid Associations Hiroshima Japan
| | - Yoichi Saito
- Department of Pathology, Kure‐Kyosai Hospital Federation of National Public Service Personnel Mutual Aid Associations Hiroshima Japan
| | - Daiki Taniyama
- Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Masanori Hanamoto
- Department of Urology, Kure‐Kyosai Hospital Federation of National Public Service Personnel Mutual Aid Associations Hiroshima Japan
| | - Hiroyuki Nose
- Department of Urology, Kure‐Kyosai Hospital Federation of National Public Service Personnel Mutual Aid Associations Hiroshima Japan
| | - Naohide Oue
- Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
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Unusual Faces of Bladder Cancer. Cancers (Basel) 2020; 12:cancers12123706. [PMID: 33321728 PMCID: PMC7763674 DOI: 10.3390/cancers12123706] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/26/2020] [Accepted: 12/07/2020] [Indexed: 02/07/2023] Open
Abstract
Simple Summary The spectrum of architectural and cytological findings in UC is wide, although transitional cell carcinoma, either papillary or flat, low- or high-grade, constitutes the majority of cases in routine practice. Some of these changes are just mere morphological variations, but others must be recognized since they have importance for the patient. The goal of this review is to compile this histological variability giving to the general pathologist a general idea of this morphological spectrum in a few pages. The review also updates the literature focusing specifically on the morphological and immunohistochemical clues useful for the diagnosis and some selected molecular studies with prognostic and/or diagnostic implications. Abstract The overwhelming majority of bladder cancers are transitional cell carcinomas. Albeit mostly monotonous, carcinomas in the bladder may occasionally display a broad spectrum of histological features that should be recognized by pathologists because some of them represent a diagnostic problem and/or lead prognostic implications. Sometimes these features are focal in the context of conventional transitional cell carcinomas, but some others are generalized across the tumor making its recognition a challenge. For practical purposes, the review distributes the morphologic spectrum of changes in architecture and cytology. Thus, nested and large nested, micropapillary, myxoid stroma, small tubules and adenoma nephrogenic-like, microcystic, verrucous, and diffuse lymphoepithelioma-like, on one hand, and plasmacytoid, signet ring, basaloid-squamous, yolk-sac, trophoblastic, rhabdoid, lipid/lipoblastic, giant, clear, eosinophilic (oncocytoid), and sarcomatoid, on the other, are revisited. Key histological and immunohistochemical features useful in the differential diagnosis are mentioned. In selected cases, molecular data associated with the diagnosis, prognosis, and/or treatment are also included.
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Tao TT, Chen J, Hu Q, Huang XJ, Fu J, Lv BD, Duan Y. Urothelial carcinoma of the bladder with abundant myxoid stroma: A case report and literature review. Medicine (Baltimore) 2020; 99:e21204. [PMID: 32664169 PMCID: PMC7360213 DOI: 10.1097/md.0000000000021204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 05/24/2020] [Accepted: 06/09/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Abundant myxoid stroma rarely occurs in urothelial carcinomas (UCs). We report an 83-year-old woman with UC of the urinary bladder with abundant myxoid stroma. We summarized the clinicopathological features, immunophenotype, diagnosis, and differential diagnosis of this type of bladder cancer, in order to improve the understanding of surgeons and pathologists. PATIENT CONCERNS An 83-year-old female presented with hematuria and frequent micturition, without odynuria, hypogastralgia, or fever. DIAGNOSIS The computed tomography scan demonstrated extensive tumors in the anterior wall of the bladder and a soft tissue shadow anterior to the sacrum. Cystoscopy showed massive wide-based tumors located on the anterior and lateral walls of the bladder, with no tumor involving the bladder neck. Multiple punch biopsies were performed, the histologic evaluation of which revealed a poorly differentiated invasive UCs with myxoid stroma. INTERVENTIONS The patient underwent a laparoscopic radical cystectomy and cutaneous ureterostomy. OUTCOMES The patient discharged without any complications. Histologic evaluation revealed an invasive UC; the most prominent feature was an abundant myxoid stroma that covered approximately 80% of the lesion and the tumor cells were arranged in cords, small nests, or a sheet-like structure. Immunohistochemically, the tumor cells were positive for CK19, CK20, VEGF, EGFR, p63, 34βE12, MUC1, GATA3, uroplakin3, and TopII (rate = 15%), while the Ki-67 proliferation index was 10%. The myxoid stroma in the mesenchyme stained positively with AB-PAS and colloidal iron, and some tumor cells stained positive for colloidal iron. Considering the histologic, histochemical, and immunohistochemical findings, a diagnosis of UC with abundant myxoid stroma was made. After surgery, the regular follow-up was continued in clinic, and there was no recurrence for 2 years. CONCLUSION Morbidity associated with UC with abundant myxoid stroma is very low. The diagnosis mainly depends on histopathological and immunohistochemical findings.
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Affiliation(s)
- Ting-Ting Tao
- Department of Urology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Traditional Chinese Medicine, Hangzhou, China
| | - Jun Chen
- Department of Urology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Traditional Chinese Medicine, Hangzhou, China
| | - Qing Hu
- Department of Urology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Traditional Chinese Medicine, Hangzhou, China
| | - Xiao-Jun Huang
- Department of Urology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Traditional Chinese Medicine, Hangzhou, China
| | - Jun Fu
- Department of Urology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Traditional Chinese Medicine, Hangzhou, China
| | - Bo-Dong Lv
- Department of Urology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Traditional Chinese Medicine, Hangzhou, China
| | - Yue Duan
- Department of Urology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Traditional Chinese Medicine, Hangzhou, China
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Lopez-Beltran A, Henriques V, Montironi R, Cimadamore A, Raspollini MR, Cheng L. Variants and new entities of bladder cancer. Histopathology 2018; 74:77-96. [DOI: 10.1111/his.13752] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 09/03/2018] [Indexed: 12/14/2022]
Affiliation(s)
| | | | - Rodolfo Montironi
- Section of Pathological Anatomy; Polytechnic University of the Marche Region; School of Medicine; Ancona Italy
| | - Alessia Cimadamore
- Section of Pathological Anatomy; Polytechnic University of the Marche Region; School of Medicine; Ancona Italy
| | - Maria R Raspollini
- Histopathology and Molecular Diagnostics; University Hospital Careggi; Florence Italy
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine; Indiana University School of Medicine; Indianapolis IN USA
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Behzatğlu K, Boyaci C, Okçu O, Hacihasanoğlu E, Çakir Y, Darakçi S. Mucinous urothelial carcinoma of the renal pelvis. Rare Tumors 2014; 6:5485. [PMID: 25568745 PMCID: PMC4274439 DOI: 10.4081/rt.2014.5485] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 08/19/2014] [Accepted: 09/03/2014] [Indexed: 11/26/2022] Open
Abstract
Urothelial carcinoma with abundant myxoid stroma is a newly-described and extremely rare entity. Since only very few cases have been reported, there is no consensus on its nomenclature. Microscopic examination revealed invasive urothelial carcinoma with widespread low-grade noninvasive areas. There were focal invasive areas in the neighborhood of the renal parenchyma. Malignant urothelial tumor/cell groups localized in the stroma had abundant myxoid/mucinous background in the invasive areas. The cytoplasm of the tumoral cells was more eosinophilic in these areas and the cells formed small groups and cords. Histochemically, PAS and Alcian Blue were positive in the cytoplasm of the tumoral cells and in the stroma while negative in the non-mucinous areas. Immunohistochemically, the tumoral cells of the mucinous invasive areas diffusely expressed MUC1 and MUC2. We discuss the origin of the mucinous/myxoid stroma, the tumor’s nature and its nomenclature with histochemical and immunohistochemical features.
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Affiliation(s)
- Kemal Behzatğlu
- Department of Pathology, Istanbul Education and Research Hospital , Istanbul, Turkey
| | - Ceren Boyaci
- Department of Pathology, Istanbul Education and Research Hospital , Istanbul, Turkey
| | - Oğuzhan Okçu
- Department of Pathology, Istanbul Education and Research Hospital , Istanbul, Turkey
| | - Ezgi Hacihasanoğlu
- Department of Pathology, Istanbul Education and Research Hospital , Istanbul, Turkey
| | - Yasemin Çakir
- Department of Pathology, Istanbul Education and Research Hospital , Istanbul, Turkey
| | - Seher Darakçi
- Department of Pathology, Istanbul Education and Research Hospital , Istanbul, Turkey
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