Clinical and pathological characteristics of XXXX : a highly aggressive variant.

@entity1 @entity5 @entity5962 @entity189 @entity2279 @entity2121 @entity876 @entity150 @entity1606 @entity8498
PURPOSE: We present preliminary clinical, histochemical and molecular findings for 5 @entity1 with @entity150 , a rare histological variant not widely recognized in the urological literature. MATERIALS AND METHODS: The 5 @entity1 were prospectively identified. In 3 cases immunohistochemical staining for expression of @entity2279 , @entity876 , @entity5962 , beta and gamma-catenin was performed on paraffin embedded tissue. Sequencing was used to identify point mutations in exons 5 to 9 of @entity876 , and exons 1 and 2 of @entity8498 . RESULTS: Of the @entity1 2 died within 1 year of presentation to our institution with rapid local extension along the bladder serosal surface and ureteral sheaths. Another @entity1 had progression to invasive disease within 22 months. In the 3 cases with immunohistochemical staining @entity876 was negative, despite positive staining of nonmicropapillary transitional cell @entity189 within the same specimen. Stains for the angiotrophic marker @entity2279 were negative. In all 3 cases normal membrane associated alpha, beta and gamma-catenin expression was present. Examination of @entity876 sequences revealed a single point mutation in exon 8 of 1 case. In 2 cases different mutations in exon 1 of @entity8498 were noted. CONCLUSIONS: @entity1606 is a rare and highly aggressive variant. @entity2121 , our study demonstrated no significant @entity876 abnormalities. The lacunar histological pattern did not appear to represent invasion of vascular spaces. Rather, these @entity5 seemed to have the ability to disrupt and replace the normal stromal matrix to achieve rapid nonendothelial extension. Thus, micropapillary histology may predict a lesser likelihood of surgical cure.
