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Lipid Cell and Micropapillary Variants of Urothelial Carcinoma of the Ureter

We report on a case of urothelial carcinoma (UC) with lipid cell and micropapillary variants in the ureter. A 64-year-old man presented with gross hematuria. Urinary cytology revealed the presence of atypical urothelial cells. Computed tomography and drip infusion/retrograde pyelography identified a...

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Autores principales: Miyama, Yu, Morikawa, Teppei, Nakagawa, Tohru, Homma, Yukio, Fukayama, Masashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677722/
https://www.ncbi.nlm.nih.gov/pubmed/26668574
http://dx.doi.org/10.1159/000442149
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author Miyama, Yu
Morikawa, Teppei
Nakagawa, Tohru
Homma, Yukio
Fukayama, Masashi
author_facet Miyama, Yu
Morikawa, Teppei
Nakagawa, Tohru
Homma, Yukio
Fukayama, Masashi
author_sort Miyama, Yu
collection PubMed
description We report on a case of urothelial carcinoma (UC) with lipid cell and micropapillary variants in the ureter. A 64-year-old man presented with gross hematuria. Urinary cytology revealed the presence of atypical urothelial cells. Computed tomography and drip infusion/retrograde pyelography identified a mass-occupying lesion in the left mid-ureter, as well as left hydronephrosis. A clinical diagnosis of left ureteral cancer was given and the patient underwent left nephroureterectomy. Microscopically, the major component of the tumor was a conventional high-grade UC. In the invasive region, however, lipid cell and micropapillary variants of UC were also observed. Upon immunohistochemical analysis, all of the components were diffusely positive for cytokeratin 7 and p53. Intense membranous expression of human epidermal growth factor receptor 2 (HER2) was also observed in both the lipid cell and micropapillary variants of UC, whereas weak and incomplete staining was observed in most regions of the conventional UC. The pathological stage was pT3 N2. Multiple times, the patient experienced recurrence of the UC in the urinary bladder and urethra. Although the patient underwent total cystectomy and urethrectomy, 52 months following the initial surgery, signs of local recurrence developed, as well as multiple lymph node and bone metastases. The patient died 75 months following the initial surgery. To the best of our knowledge, this is the first reported case of a lipid cell variant of ureteral UC. The overexpression of HER2 may be associated with both the lipid cell and micropapillary variants of UC.
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spelling pubmed-46777222015-12-14 Lipid Cell and Micropapillary Variants of Urothelial Carcinoma of the Ureter Miyama, Yu Morikawa, Teppei Nakagawa, Tohru Homma, Yukio Fukayama, Masashi Case Rep Oncol Published online: November, 2015 We report on a case of urothelial carcinoma (UC) with lipid cell and micropapillary variants in the ureter. A 64-year-old man presented with gross hematuria. Urinary cytology revealed the presence of atypical urothelial cells. Computed tomography and drip infusion/retrograde pyelography identified a mass-occupying lesion in the left mid-ureter, as well as left hydronephrosis. A clinical diagnosis of left ureteral cancer was given and the patient underwent left nephroureterectomy. Microscopically, the major component of the tumor was a conventional high-grade UC. In the invasive region, however, lipid cell and micropapillary variants of UC were also observed. Upon immunohistochemical analysis, all of the components were diffusely positive for cytokeratin 7 and p53. Intense membranous expression of human epidermal growth factor receptor 2 (HER2) was also observed in both the lipid cell and micropapillary variants of UC, whereas weak and incomplete staining was observed in most regions of the conventional UC. The pathological stage was pT3 N2. Multiple times, the patient experienced recurrence of the UC in the urinary bladder and urethra. Although the patient underwent total cystectomy and urethrectomy, 52 months following the initial surgery, signs of local recurrence developed, as well as multiple lymph node and bone metastases. The patient died 75 months following the initial surgery. To the best of our knowledge, this is the first reported case of a lipid cell variant of ureteral UC. The overexpression of HER2 may be associated with both the lipid cell and micropapillary variants of UC. S. Karger AG 2015-11-24 /pmc/articles/PMC4677722/ /pubmed/26668574 http://dx.doi.org/10.1159/000442149 Text en Copyright © 2015 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Published online: November, 2015
Miyama, Yu
Morikawa, Teppei
Nakagawa, Tohru
Homma, Yukio
Fukayama, Masashi
Lipid Cell and Micropapillary Variants of Urothelial Carcinoma of the Ureter
title Lipid Cell and Micropapillary Variants of Urothelial Carcinoma of the Ureter
title_full Lipid Cell and Micropapillary Variants of Urothelial Carcinoma of the Ureter
title_fullStr Lipid Cell and Micropapillary Variants of Urothelial Carcinoma of the Ureter
title_full_unstemmed Lipid Cell and Micropapillary Variants of Urothelial Carcinoma of the Ureter
title_short Lipid Cell and Micropapillary Variants of Urothelial Carcinoma of the Ureter
title_sort lipid cell and micropapillary variants of urothelial carcinoma of the ureter
topic Published online: November, 2015
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677722/
https://www.ncbi.nlm.nih.gov/pubmed/26668574
http://dx.doi.org/10.1159/000442149
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