Inverted urothelial papilloma of the upper urinary tract: Description of two cases with systematic literature review
| Autor: | José I. López, Raffaella Santi, Ilaria Camilla Galli, Gabriella Nesi, Vincenzo Canzonieri |
|---|---|
| Přispěvatelé: | Santi, R., Galli, I. C., Canzonieri, V., Lopez, J. I., Nesi, G. |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Pathology medicine.medical_specialty Histology Inverted urothelial papilloma Microsatellite instability Molecular markers Upper urinary tract 030204 cardiovascular system & hematology Molecular marker Malignancy Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Ureter Atypia medicine lcsh:Pathology Humans Kidney Pelvis Urothelium Aged Papilloma Inverted Ureteral Neoplasms business.industry Research General Medicine Middle Aged medicine.disease Kidney Neoplasms Urothelial Papilloma medicine.anatomical_structure 030220 oncology & carcinogenesis Female Ureteritis Cystica business Renal pelvis lcsh:RB1-214 |
| Zdroj: | Diagnostic Pathology, Vol 15, Iss 1, Pp 1-10 (2020) Diagnostic Pathology |
| DOI: | 10.1186/s13000-020-00961-9 |
| Popis: | Background Inverted urothelial papilloma (IUP) of the upper urinary tract is an uncommon benign tumour that occasionally presents as a polypoid mass causing urinary obstruction. Histologically, IUP is characterised by a proliferating urothelium arranged in cords and trabeculae, in continuity with overlying intact epithelium, and extending into the lamina propria in a non-invasive, endophytic manner. Cytological atypia is minimal or absent. Top differential diagnoses include urothelial carcinoma with inverted growth pattern and florid ureteritis cystica. Although urothelial carcinomas of the upper urinary tract with prominent inverted growth pattern commonly harbour microsatellite instability, the role of the mutator phenotype pathway in IUP development is still unclear. The aim of this study was to describe two additional cases of IUP of the upper urinary tract, along with an extensive literature review. Case presentation We observed two polypoid tumours originating in the renal pelvis and the distal ureter, respectively. Both patients, a 76-year-old woman and a 56-year-old man, underwent surgery because of the increased likelihood of malignancy. Histology was consistent with IUP and patients are alive and asymptomatic after long-term follow-up (6 years for the renal pelvis lesion and 5 years for the ureter lesion). The tumours retained the expression of the mismatch-repair protein MLH1, MSH2, and PMS2 whereas loss of MSH6 was found in both cases. Conclusions When completely resected, IUP does not require rigorous surveillance protocols, such as those for urothelial carcinoma and exophytic urothelial papilloma. It is therefore important for the surgical pathologist to be aware of this rare entity in order to ensure correct patient management. |
| Databáze: | OpenAIRE |
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