title: Pleomorphic giant cell carcinoma of the urinary bladder: an extreme form of tumour de-differentiation.
abstract: OBJECTIVE
  Vesical pleomorphic giant cell carcinoma (PGCC) is a variant of urothelial carcinoma (UC) characterized by highly pleomorphic tumour with giant cells. Fewer than 10 cases have been reported, and our aim was to determine the clinical and pathological features of a series of tumours from a specialized uropathology laboratory.
  
  
  RESULTS
  Thirteen cases of PGCC of the bladder were identified. There were nine males and four females, ranging in age from 53 to 92 years (mean 72 years). Associated conventional high-grade UC was seen in eight cases, while three cases also had micropapillary UC and one plasmacytoid UC. UC in situ (CIS) was present in five cases and occasional bizarre cells were seen in both UC and CIS. The proportion of PGCC present varied from 40% to 100% of tumour. Immunostaining performed on 10 cases showed uniform positivity for CK 8/18 and AE1/AE3, while most tumours were positive for CK7, CK20, uroplakin III and GATA binding protein 3 (GATA3). β-human chorionic gonadotrophin (β-hCG) was negative. Of 10 patients with follow-up, five died within 1 year and four are alive with tumour.
  
  
  CONCLUSIONS
  The association of PGCC with UC and an overlap in immunoexpression suggests that PGCC represents an extreme form of UC de-differentiation.
authors.affiliation: Aquesta Pathology, Brisbane, Qld, Australia.|University of Queensland, Brisbane, Qld, Australia.
authors.forename: Hemamali
authors.initials: H
authors.lastname: Samaratunga
authors.affiliation: Aquesta Pathology, Brisbane, Qld, Australia.|Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, Wellington, New Zealand.
authors.forename: Brett
authors.initials: B
authors.lastname: Delahunt
authors.affiliation: Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Egevad
authors.affiliation: Aquesta Pathology, Brisbane, Qld, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Adamson
authors.affiliation: Brisbane Private Hospital, Brisbane, Qld, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Hussey
authors.affiliation: Greenslopes Hospital, Brisbane, Qld, Australia.
authors.forename: Greg
authors.initials: G
authors.lastname: Malone
authors.affiliation: Sunshine Coast Private Hospital, Buderim, Qld, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Hoyle
authors.affiliation: Sunshine Coast University Private Hospital, Birtinya, Qld, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Nathan
authors.affiliation: St Vincent's Private Hospital, Lismore, NSW, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Kerle
authors.affiliation: Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, Wellington, New Zealand.
authors.forename: Peter
authors.initials: P
authors.lastname: Ferguson
authors.affiliation: Department of Surgery and Anaesthesia, Wellington School of Medicine and Health Sciences, Wellington, New Zealand.
authors.forename: John N
authors.initials: JN
authors.lastname: Nacey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D018286:Carcinoma, Giant Cell / Q000473:pathology*; D002295:Carcinoma, Transitional Cell / Q000473:pathology; D054337:Cell Dedifferentiation; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D001749:Urinary Bladder Neoplasms / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor
keywords: bladder; malignancy; pleomorphic giant cell carcinoma; urothelial carcinoma