방광에 생긴 미세유두변이 요로상피세포암종의 임상 및 병리학적 분석
Clinicopathologic Analysis of the Micropapillary Variant of Urothelial Carcinoma in Urinary
이경지, 이아원, 이교영, 최영진, 강창석, 심상인,
소속 상세정보
이경지 ( Lee Kyung-Ji )
가톨릭대학교 의과대학 병원병리학교실
이아원 ( Lee Ah-Won )
가톨릭대학교 의과대학 병원병리학교실
이교영 ( Lee Kyo-Young )
가톨릭대학교 의과대학 병원병리학교실
최영진 ( Choi Yeong-Jin )
가톨릭대학교 의과대학 병원병리학교실
강창석 ( Kang Chang-Suk )
가톨릭대학교 의과대학 병원병리학교실
심상인 ( Shim Sang-In )
가톨릭대학교 의과대학 병원병리학교실
KMID : 0357920060400040263
Abstract
Background: Micropapillary urothelial carcinoma of urinary bladder is a rare and aggressive subtype of urothelial carcinoma (UC).
Methods and Results: Seven UCs with a micropapillary component (MPC) were identified by reviewing 135 cystectomy specimens of UC (5.2% in incidence). MPC was associated with conventional UC in 6 cases and the plasmacytoid variant of UC in 1 case. Lymph node metastasis, that characteristically contained MPC was present in 60% (3 out of 5 cases of regional lymph node dissection). Three patients with extensive MPC showed laminar propria invasion (pT1; 33%) and perivesical fat invasion (pT3; 67%). Two out of 3 patients with extensive MPC showed distant metastasis into the colon after cystectomy. The colonic lesions showed exclusively micropapillary differentiation. Four patients with focal or moderate MPC (pT2, 25% pT3, 75%) were alive without disease at the time of writing this article. All 3 cases with extensive MPC had surface and/or invasive MPC on the prior TURB specimen. Immunohistochemically, the tumor cells were positive for cytokeratin 7, cytokeratin 20, EMA and E-cadherin and tissue retraction spaces that simulate lymphatic spaces were negative for CD34 in all 7 cases.
Conclusions: This study suggests that the micropapillary growth pattern in UC is a manifestation of aggressive behavior and UC with MPC must be included as part of the differential diagnosis when dealing with a metastatic lesion with a micropaillary structure.
키워드
Micropapillary;Urothelial carcinoma;Urinary bladder
원문 및 링크아웃 정보
등재저널 정보