A retrospective immunohistochemical and clinicopathological study of small cell carcinomas of the urinary tract.
BACKGROUND
To investigate the immunohistochemical and clinicopathological behaviors of primary urinary tract small cell carcinomas (SCCs).


METHODS
A retrospective study of 10 cases of urinary tract SCC (7 men and 3 women, average age, 54; range, 35-78 years) at Chang Gung Memorial Hospital is reported. Among these cases, 3 tumors arose from the kidney, 2 from the renal pelvis, 2 from the ureter, and 3 from the bladder. Clinical and follow-up data were obtained. Histological and immunohistochemical studies with antibodies to neuroendocrine (NE) markers were conducted.


RESULTS
The most prominent common feature of the 10 SCCs was their cell histopathology: small to medium-sized round to spindle-shaped cells with scanty cytoplasm, hyperchromatic nuclei, and inconspicuous nucleoli. Immunostaining revealed positive neuron-specific enolase (NSE) reactivity in 10 of 10 tumors, but there was focal and weak staining for chromogranin-A (CgA) in 4 of 10 tumors. The 7 patients with vimentin-positive SCCs all developed metastatic lesions, and 5 of them expired within 1 year.


CONCLUSIONS
SCCs of the urinary tract system share similar histopathological features and NE markers with their pulmonary counterpart. NSE was expressed more consistently than CgA in these tumors. However, the preferential expression of NSE and intensity of immunostaining of these 2 NE markers did not predict the clinical outcome of these patients. The presence of both SCC and transitional cell carcinoma or SCC alone did not foretell the clinical outcome either. Patients with the presence of vimentin in the tumor tissues appeared to have poorer prognoses with early metastasis and mortality.
Chuang
Cheng-Keng
CK
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC. chuang89@cgmh.org.tw
Liao
Shuen-Kuei
SK
D000328:Adult; D000368:Aged; D018288:Carcinoma, Small Cell / Q000737:chemistry / Q000473:pathology*; D053379:Chromogranin A; D002864:Chromogranins / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014571:Urologic Neoplasms / Q000737:chemistry / Q000473:pathology*
D053379:Chromogranin A; D002864:Chromogranins