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Puzyrenko A, Nomani L, Iczkowski K, Giorgadze T. Small cell carcinoma of the urinary bladder: Distinctive cytological characteristics and Cyto-histologic correlation. Ann Diagn Pathol 2022; 59:151947. [DOI: 10.1016/j.anndiagpath.2022.151947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 11/01/2022]
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Systematic review and two new cases of primary upper urinary tract neuroendocrine carcinomas. Cancer Treat Res Commun 2018; 17:23-30. [PMID: 30326420 DOI: 10.1016/j.ctarc.2018.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/11/2018] [Accepted: 10/08/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Upper urinary tract neuroendocrine carcinoma (UUT-NEC) is extremely rare and has a poor prognosis. Although a few cases of successful treatment have been reported, no treatment has shown established efficacy. PATIENTS AND METHODS We analyzed 70 UUT-NEC patients, including 68 with small cell neuroendocrine carcinoma (SCNEC) and large cell neuroendocrine carcinoma (LCNEC) reported between 1985 and 2017 and 2 treated at our hospital. RESULTS Median patient age was 66 years, 58.6% were men, and 60% were of Asian descent. Most UUT-NECs were SCNEC (68; 95.7%), whereas LCNEC was very rare (2; 2.9%). More than half of the patients had accompanying other histological components, the most common being urothelial carcinoma (51.5%), whereas 41.4% had NEC alone. Of the 70 patients, 27 underwent additional therapy (e.g., chemotherapy and radiotherapy) along with surgery. Median survival was 15 months. In univariate analysis, stages T1-2 disease showed better prognosis than stages T3-4 (P < 0.001). Additional treatment (e.g., chemotherapy and radiotherapy) significantly improved prognosis (P = 0.014). Moreover, platinum-based chemotherapy also was associated with improved prognosis (P = 0.017). For platinum-based chemotherapy, multicollinearity with additional treatments was strong, and, thus, these data were not included in the analysis. Multivariate analysis revealed pathological stage (T1-2 vs. T3-4; P = 0.003) and additional treatment (P = 0.028) to be independent predictors of improved prognosis. CONCLUSION Although UUT-NEC has a poor prognosis, additional treatment along with surgery and therapeutic intervention and stage T1-2 disease are independent factors to improve prognosis.
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Yang T, Li Y, Li J, Liu J, Deng X, Wang G. Diagnostic Value Comparison of Urothelium Carcinoma Among Urine Exfoliated Cells Fluorescent In Situ Hybridization (FISH) Examination, Computerized Tomography (CT) Scan, and Urine Cytologic Examination. Med Sci Monit 2018; 24:5788-5792. [PMID: 30121694 PMCID: PMC6111772 DOI: 10.12659/msm.910134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study aimed to compare the clinical effectiveness of urine exfoliated cells FISH examination, CT scan, and urine cytologic examination on the diagnosis of upper urinary tract urothelium carcinoma with hematuresis symptom. MATERIAL AND METHODS A total of 30 patients with suspicious upper urinary tract urothelium carcinoma between Aug 2010 and Aug 2011 were enrolled, including 23 males and 7 females. All the subjects received urine exfoliated cells FISH examination, CT scan, and urine cytologic examination. Twenty-one cases were diagnosed as urothelium carcinoma, including 14 cases of carcinoma of renal pelvis and 7 cases of carcinoma of ureter. There were 6 cases in stage Ta/T1, 12 cases in stage T2, and 3 cases in T3/T4. The other 9 cases consisted of 1 case of neuroendocrine carcinoma of the renal pelvis, 2 cases of nephrotuberculosis, and 6 cases of renal clear cell carcinoma. RESULTS The total sensitivity of FISH examination, CT scan, and urine cytologic examination on upper urinary tract urothelium carcinoma was 85.7%, 66.7%, and 28.6%, respectively (P<0.05). The tumor staging detection on Ta/T1, T2, and T3/T4 by FISH was 66.7%, 91.7%, 100%; by CT scan 33.3%, 75.0%, 100%; and by urine cytologic examination 0%, 25.0%, and 100%. Their diagnostic specificities were 88.9%, 77.8%, and 100%, respectively (P<0.05). CONCLUSIONS The diagnostic sensitivity on upper urinary tract urothelium carcinoma was highest in FISH examination, followed by CT scan and urine cytologic examination. FISH technique obviously improves the diagnosis of upper urinary tract urothelium carcinoma.
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Affiliation(s)
- Tao Yang
- Department of Urinary Surgery, Hebei General Hospital, Shijiazhuang, Hebei, China (mainland)
| | - Yan Li
- Department of Hematology, Hebei General Hospital, Shijiazhuang, Hebei, China (mainland)
| | - Jing Li
- Department of Hematology, Hebei Province Chinese Medicine Hospital, Shijiazhuang, Hebei, China (mainland)
| | - Junjiang Liu
- Department of Urinary Surgery, Hebei General Hospital, Shijiazhuang, Hebei, China (mainland)
| | - Xinna Deng
- Department of Oncology and Immunotherapy, Hebei General Hospital, Shijiazhuang, Hebei, China (mainland)
| | - Gang Wang
- Department of Urinary Surgery, Hebei General Hospital, Shijiazhuang, Hebei, China (mainland)
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Zhong W, Lin R, Zhang L, Jin C, Li X, He Q, Gong K, He Z, Zhou L. Clinicopathologic characteristics, therapy and outcomes of patients with primary ureteral small cell carcinoma: a case series and systematic review of the literature. Onco Targets Ther 2017; 10:4105-4111. [PMID: 28860819 PMCID: PMC5566501 DOI: 10.2147/ott.s138769] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose The aim of this case series was to review the standard diagnosis and treatment procedures of primary small cell carcinoma (SCC) in our institution and discuss the clinicopathologic characteristics, treatments and outcomes of patients with primary ureteral SCC. Patients and methods Patients diagnosed with ureteral SCC in Peking University First Hospital, Beijing, China, from January 2007 to December 2016 were included. In addition, we performed a systematic literature review, in October 2016, on case reports and case series of ureteral SCC. The clinicopathologic characteristics, treatments and outcomes of this rare disease were analyzed. Results A total of 32 patients were included in our analysis (4 cases from our institution and 28 cases from the literature). Most patients (71.0%) were male with an average age of 66.6 years (range 48–80 years). The most common symptoms were hematuria (n=14, 48.3%) and flank pain (n=14, 48.3%). All patients underwent surgery, with 12 (37.5%) patients undergoing multimodality therapy. Regional or distant recurrences developed in 11 patients, among which only 1 patient had bladder recurrence. The overall median survival of the patients was 17 months, with 1- and 3-year survival rates of 51.9% and 30.3%, respectively. In a univariate analysis, female (P=0.009), pure SCC (P=0.03) and advanced T stage (P=0.04) were associated with worse overall survival. Conclusion Ureteral SCCs are extremely rare neoplasms with aggressive natural history and poor prognosis. T stage, tumor components and gender may be important factors influencing prognosis. A multimodality treatment is recommended for management. However, further studies are needed to improve the treatment strategy.
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Affiliation(s)
- Wenlong Zhong
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Rongcheng Lin
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Lei Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Chengyue Jin
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Qun He
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Kan Gong
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Zhisong He
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
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Ainechi S, Pambuccian SE, Wojcik EM, Barkan GA. Cytomorphologic features and differential diagnosis of neoplasms with small cell features in liquid-based urinary tract cytologic specimens. J Am Soc Cytopathol 2015; 4:295-306. [PMID: 31051743 DOI: 10.1016/j.jasc.2015.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 07/18/2015] [Accepted: 07/20/2015] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Urinary tract cytology (UTCy) allows the accurate diagnosis of high grade urothelial carcinoma. Rare malignancies characterized by the presence of small cells may be more difficult to recognize, however. The aim of this study was to review our experience with liquid-based (ThinPrep) UTCy specimens showing small atypical cells and characterize their cytomorphology, potential differences from previously reported morphologic features, and discuss their differential diagnostic considerations. MATERIALS AND METHODS Among 18,859 UTCy specimens reviewed during a 13-year period (2001-2012), we identified 13 cases corresponding to surgical pathology specimens diagnosed as small cell carcinoma (6), melanoma (3), lymphoma (3), and leukemic involvement of the urinary tract (1). We recorded the original diagnoses made on these cases and 10 cytomorphologic features that could aid in their diagnosis. RESULTS We identified 13 cases in UTCy of 7 men and 6 women; 11 of which were diagnosed as positive or suspicious for malignancy. In 8 out of 13 cases (62%) the type of malignancy was correctly reported. Of the 10 recorded features, cellular clustering and nuclear molding were seen only in small cell carcinoma, whereas prominent nucleoli and an inflammatory background or diathesis were noted in lymphoma and melanoma cases. Intracellular pigment and multinucleation were recorded in melanoma cases. CONCLUSION The presence of small atypical cells in liquid-based UTCy should raise the suspicion of underlying malignancy involving the urinary tract. Cell clustering, nuclear molding, and hyperchromasia are helpful hints for the diagnosis of small cell carcinoma and the presence of small atypical cells with prominent nucleoli raises the possibility of lymphoma or melanoma.
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Affiliation(s)
- Sanaz Ainechi
- Department of Pathology and Laboratory Medicine, Albany Medical Center, MC-81, 47 New Scotland Ave., Albany, New York
| | - Stefan E Pambuccian
- Department of Pathology, Loyola University Healthcare System, 2160 South First Avenue, Maywood, Illinois
| | - Eva M Wojcik
- Department of Pathology, Loyola University Healthcare System, 2160 South First Avenue, Maywood, Illinois
| | - Güliz A Barkan
- Department of Pathology, Loyola University Healthcare System, 2160 South First Avenue, Maywood, Illinois.
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Marchevsky AM, Wick MR. Diagnostic difficulties with the diagnosis of small cell carcinoma of the lung. Semin Diagn Pathol 2015; 32:480-8. [DOI: 10.1053/j.semdp.2015.11.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Small cell carcinoma of the upper urinary tract (UUT-SCC): report of a rare entity and systematic review of the literature. Cancer Treat Rev 2011; 37:366-72. [PMID: 21257269 DOI: 10.1016/j.ctrv.2010.12.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 12/12/2010] [Accepted: 12/18/2010] [Indexed: 12/11/2022]
Abstract
BACKGROUND Primary small cell carcinoma of the upper urinary tract (UUT-SCC) is an extremely uncommon disease. The current knowledge of these rare tumors is mainly based on case reports or small series. METHODS We reported two cases and performed a systematic literature search from 1970 to 2010 for articles on UUT-SCC. Overall, 40 patients with UUT-SCC were reviewed, a database was generated to analyze clinical characteristics, pathological features and therapy outcomes and to attempt in identifying prognostic factors. RESULTS For the 39 cases with available data, median age was 66.5 years and male-female ratio was 2:1. An Asian ethnic background was more common (59%). Surgery was the standard treatment given to all patients. In 67% of cases, SCC coexisted with another malignant component, including urothelial carcinoma in 62% of patients. Overall median survival was 15 months and the 1-, 2- and 3-year survival rates were 58.4%, 38.1% and 23.8%, respectively. Of all cases, 53.8% developed detectable metastasis in a median delay of 13 months. Pathological stage was the only significant prognostic factor found (p=0.01). Patients who received adjuvant chemotherapy seem to have a higher median survival comparatively to those who did not receive chemotherapy but this was not statistically significant (24 vs. 12 months, p=0.56). CONCLUSIONS UUT-SCC is an extremely rare tumor characterized by an aggressive clinical course. Local or distant metastases are frequent and survival is poor. Pathological stage appeared to be a prognostic factor for overall survival.
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