原创力文档primary bladder adenocarcinoma versus metastatic colorectal adenocarcinoma a persisting diagnostic challenge原发性膀胱腺癌和转移性结直肠腺癌一个持久化诊断挑战.pdfVIP
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primary bladder adenocarcinoma versus metastatic colorectal adenocarcinoma a persisting diagnostic challenge原发性膀胱腺癌和转移性结直肠腺癌一个持久化诊断挑战
Roy et al. Diagnostic Pathology 2012, 7:151
/content/7/1/151
RESEARCH Open Access
Primary bladder adenocarcinoma versus
metastatic colorectal adenocarcinoma:
a persisting diagnostic challenge
1 1 1,2 1 1,3*
Somak Roy , Matthew A Smith , Kathy M Cieply , Marie B Acquafondata and Anil V Parwani
Abstract
Aim: This study attempted to distinguish primary bladder adenocarcinoma (PBA) from metastatic colonic
adenocarcinomas (MCA), which is a difficult diagnostic and clinical problem.
Methods: Twenty-four cases of bladder adenocarcinomas (12 primary 12 metastatic colorectal) were included in
the study with urothelial carcinoma (UC) and colonic adenocarcinoma (CA) as controls. A panel of
immunohistochemical (IHC) stains along with fluorescence in-situ hybridization (FISH), using the UroVysion probe
set, was performed.
Results: The majority of the PBAs presented with advanced disease. Enteric histologic subtype was the most
common morphological variant. Strong nuclear with cytoplasmic-membranous staining of β-catenin was seen in
75% of MCA and only 16.7% PBA (10% staining cells). Although abnormal nuclear staining with E-cadherin was
seen in both PBA and MCA, it was more frequent in former. CK-7, CK-20, villin and CDX-2 stains were not helpful in
distinguishing the two entities. FISH did not reveal any unique differences in chromosomal abnormality between
the two groups.
Conclusion: Although there was a statistically significant difference in β-catenin and E-cadherin staining between
two groups, we did not find any IHC or FISH marker that was specific for PBA. Distinction between PBA and MCA
remains a diagnostic problem and clinical correlation is vital before rendering a diagno
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