title: Cytomorphology of high-grade neuroendocrine carcinoma of the urinary tract.
abstract: High-grade neuroendocrine carcinoma of the bladder is a rare malignant tumor with poor prognosis. We present the cytomorphologic features of six retrospectively identified cases which displayed high-grade tumors with neuroendocrine differentiation in bladder washings. Cytology specimens showed small-to-medium-sized tumor cells with powdery chromatin, inconspicuous nucleoli, and ill-defined nuclear membranes. Tumor fragments showed prominent nuclear molding and single-cell necrosis. All cases also revealed a varying proportion of tumor cells resembling the usual transitional-cell carcinoma. Biopsy specimens from five cases demonstrated high-grade transitional-cell carcinoma with areas resembling small-cell carcinoma. In one case the entire tumor consisted of classic small-cell carcinoma and failed to show any areas of transitional-cell differentiation. All cases were positive for neuroendocrine markers. Neuroendocrine carcinomas of the urinary bladder are rare, with cytological features similar to high-grade neuroendocrine carcinomas seen in other organs. They can be accurately diagnosed cytologically, and an awareness of the cytomorphologic features is important.
authors.affiliation: Division of Cytopathology and Cytometry, Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104, USA.
authors.forename: G
authors.initials: G
authors.lastname: Acs
authors.forename: P K
authors.initials: PK
authors.lastname: Gupta
authors.forename: Z W
authors.initials: ZW
authors.lastname: Baloch
mesh_terms: D000368:Aged; D018288:Carcinoma, Small Cell / Q000737:chemistry / Q000473:pathology*; D002295:Carcinoma, Transitional Cell / Q000737:chemistry / Q000473:pathology*; D002467:Cell Nucleus / Q000473:pathology; D002864:Chromogranins / Q000032:analysis; D003581:Cytodiagnosis; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000032:analysis; D012189:Retrospective Studies; D016708:Synaptophysin / Q000032:analysis; D007507:Therapeutic Irrigation; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000737:chemistry / Q000473:pathology*
chemical_list: D002864:Chromogranins; D016708:Synaptophysin; D010751:Phosphopyruvate Hydratase