title: Cytologic features of sarcomatoid carcinoma of the urinary bladder: a case report.
abstract: Sarcomatoid carcinoma of the urinary bladder is a rare entity, whose histogenesis and biological behavior remain controversial. The cytological literature on sarcomatoid carcinoma in voided urine is very scarce. Clinically, the diagnosis of this tumor can be made by computed tomography (CT), magnetic resonance imaging (MRI), cytology, and biopsy material. In this study, cytology, histopathology, and radiological imaging were employed in order to reach a diagnosis of sarcomatoid carcinoma. CT imaging showed increased thickness of the bladder wall associated to a polypoid mass. MRI showed a 4-cm sized, broadly necked polypoid mass with calcification and ulceration at the right side of the bladder wall. T2W1 imaging showed low signal. Voided urinary cytology showed a scattered cellular presentation. The tumor cells had a high nucleo- cytoplasmic ratio, with elongated cytoplasm with faint with indistinct cytoplasm border. The nucleus was oval to round, with large and irregular nucleoli and irregular nuclear membrane. These tumor cells were positive for cytokeratin (CKAE1/AE3), vimentin, p53, carcinoembryonic antigen (CEA), α1-smooth muscle actin (SMA) by the immunoperoxidase staining. Histopathology showed spindle-shaped and clumped large tumor cells with abundant cytoplasm. Mitotic figures were frequently seen and varied from area to area (50% of the tumor cells were positive for MIB1).
authors.affiliation: Department of Pathology, Morimoto Higashi-Sumiyoshi Hospital, Higashi-Sumiyoshi, Osaka, Japan.
authors.forename: Nobuzo
authors.initials: N
authors.lastname: Iwa
authors.forename: Shuji
authors.initials: S
authors.lastname: Ito
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Takegaki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ikura
authors.forename: Tadao K
authors.initials: TK
authors.lastname: Kobayashi
authors.forename: Satoru
authors.initials: S
authors.lastname: Yasukawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kobayashi
mesh_terms: D000199:Actins / Q000235:genetics / Q000378:metabolism; D000368:Aged; D002272:Carcinoembryonic Antigen / Q000235:genetics / Q000378:metabolism; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology*; D003581:Cytodiagnosis; D004847:Epithelial Cells / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007633:Keratins / Q000235:genetics / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D016159:Tumor Suppressor Protein p53 / Q000235:genetics / Q000378:metabolism; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014746:Vimentin / Q000235:genetics / Q000378:metabolism
chemical_list: D000199:Actins; D002272:Carcinoembryonic Antigen; D016159:Tumor Suppressor Protein p53; D014746:Vimentin; D007633:Keratins