Specific types of bladder cancer

Bladder cancer shows rare variants and special subtypes with diverse prognostic importance and therefore may necessitate different therapeutic approaches. For pathologists it is important to histologically diagnose and specify such variants. Nested variants of urothelial carcinoma with inconspicuous...

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Bibliographic Details
Published in:Der Pathologe 2016-02, Vol.37 (1), p.40-51
Main Authors: Bertz, S, Hartmann, A, Knüchel-Clarke, R, Gaisa, N T
Format: Article
Language:ger
Subjects:
Adenocarcinoma - classification
Adenocarcinoma - pathology
Adenocarcinoma - therapy
Carcinoma, Small Cell - classification
Carcinoma, Small Cell - pathology
Carcinoma, Small Cell - therapy
Carcinoma, Squamous Cell - classification
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - therapy
Carcinoma, Transitional Cell - classification
Carcinoma, Transitional Cell - pathology
Carcinoma, Transitional Cell - therapy
Cell Transformation, Neoplastic - pathology
Disease Progression
Guideline Adherence
Humans
Neoplasm Invasiveness
Prognosis
Urinary Bladder - pathology
Urinary Bladder Neoplasms - classification
Urinary Bladder Neoplasms - pathology
Urinary Bladder Neoplasms - therapy
Urothelium - pathology
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Summary:Bladder cancer shows rare variants and special subtypes with diverse prognostic importance and therefore may necessitate different therapeutic approaches. For pathologists it is important to histologically diagnose and specify such variants. Nested variants of urothelial carcinoma with inconspicuous, well-formed tumor cell nests present with an aggressive course. The plasmacytoid variant, which morphologically resembles plasma cells is associated with a shorter survival time and a high frequency of peritoneal metastasis. Micropapillary urothelial carcinoma with small papillary tumor cell islands within artificial tissue retraction spaces and frequent lymphovascular invasion also has a poor prognosis. Other important rare differential variants listed in the World Health Organization (WHO) classification are microcystic, lymphoepithelioma-like, sarcomatoid, giant cell and undifferentiated urothelial carcinomas. Additionally, there are three special types of bladder cancer: squamous cell carcinoma, adenocarcinoma and small cell neuroendocrine carcinoma of the bladder. These tumors are characterized by pure squamous cell or glandular differentiation and are sometimes less responsive to adjuvant (chemo)therapy. Small cell carcinoma of the bladder mimics the neuroendocrine features of its pulmonary counterpart, shows an aggressive course but is sensitive to (neo-)adjuvant chemotherapy. The morphology and histology of the most important variants and special types are discussed in this review.
ISSN:1432-1963
DOI:10.1007/s00292-015-0129-5