Shariat - Figure 36
Plasmacytoid Variant
FIG. 36: A third variant histology of importance in T1 bladder cancer is plasmacytoid carcinoma.[40] These cells resemble plasma cells. Discohesive growth, loss of cytokeratin (CK) 20, high rates of Ki67 labeling and p53 expression, and loss of E-cadherin are typical features. This is often a locally infiltrative and highly aggressive tumor. The diagnosis is difficult because of a lack of hematuria, deceiving coarse folds on cystoscopy, rare atypical cells on cytology (which is often negative), and a unique pattern of spread along the tissue perivesically and around the ureter. These patients also are best treated with an immediate radical cystectomy, despite being T1 high grade.
References
Mochini M. Nat Rev Urol. In press
Dayyani F, Czerniak BA, Sircar K, et al. Plasmacytoid urothelial carcinoma, a chemosensitive cancer with poor prognosis, and peritoneal carcinomatosis. J Urol. 2013;189:1656−61 http://dx.doi.org/10.1016/j.juro.2012.11.084
Keck B, Wach S, Stoehr R, et al. Plasmacytoid variant of bladder cancer defines patients with poor prognosis if treated with cystectomy and adjuvant cisplatin-based chemotherapy. BMC Cancer. 2013;13:71 http://doi.org/10.1186/1471-2407-13-71
