PMID- 21383609
OWN - NLM
STAT- MEDLINE
DCOM- 20110512
LR  - 20151119
IS  - 1532-0979 (Electronic)
IS  - 0147-5185 (Linking)
VI  - 35
IP  - 4
DP  - 2011 Apr
TI  - Lymphoepithelioma-like carcinoma of the urinary bladder: clinicopathologic, 
      immunohistochemical, and molecular features.
PG  - 474-83
LID - 10.1097/PAS.0b013e31820f709e [doi]
AB  - INTRODUCTION: Lymphoepithelioma-like carcinoma (LELC) in the urinary tract is a 
      rare malignancy, named for its resemblance to nasopharyngeal undifferentiated 
      carcinoma or lymphoepithelioma. Investigation of immunohistochemical and 
      molecular characteristics of bladder LELC is limited. The pathogenesis and 
      biological behavior of these tumors are controversial. MATERIALS AND METHODS: We 
      examined clinicopathologic features of the urinary tract LELC, including light 
      microscopy; immunohistochemistry for cytokeratin 7 (CK7), CK20, 34betaE12, p53, p63, 
      alpha-methylacyl-CoA racemase, thyroid transcription factor-1, Epstein-Barr virus 
      latent membrane protein-1, and CD30; in situ hybridization for human 
      papillomavirus; and UroVysion fluorescence in situ hybridization (FISH). RESULTS: 
      We identified tumors from 34 patients, the largest series to date, (male:female, 
      2.8:1), ranging from 54 to 84 years of age (mean, 70 years). Urothelial carcinoma 
      in situ was identified in 50% of patients. 34betaE12 (75%), CK7 (57%), and p63 (53%) 
      were frequently positive in tumor cells, whereas thyroid transcription factor-1 
      and CD30 were consistently negative. Expression of p53 was noted in a subset of 
      tumors (61%), whereas CK20 staining was negative with weak positivity in a single 
      case. UroVysion FISH showed frequent chromosomal abnormalities similar to those 
      of urothelial carcinoma. In tumors with concurrent urothelial, squamous, 
      sarcomatoid, and glandular components, identical FISH abnormalities were noted in 
      both areas. In situ hybridization for human papillomavirus and immunostaining for 
      Epstein-Barr virus were negative in all studied lesions. Five patients with pure 
      or predominant LELC tumors treated with transurethral resection and followed by 
      chemotherapy were alive without evidence of disease at 2 to 5 years. In contrast, 
      2 patients treated in this manner with <50% LELC morphology had death from 
      disease or distant metastasis. DISCUSSION: Urinary tract LELC is a rare 
      histologic variant of urothelial carcinoma. The frequent presence of UroVysion 
      FISH abnormalities, urothelial carcinoma in situ, and p53 positivity by 
      immunohistochemistry in cases of urinary tract LELC suggests a similar 
      pathogenesis to high-grade invasive urothelial carcinoma. In contrast to typical 
      urothelial carcinoma, CK20 is frequently negative in LELC. Our findings support 
      the hypothesis that pure or predominant LELC may be treated with transurethral 
      resection and chemotherapy. However, a large-scale study with long-term follow-up 
      is needed to better understand the biological behavior of urinary bladder LELC.
FAU - Williamson, Sean R
AU  - Williamson SR
AD  - Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, 
      USA.
FAU - Zhang, Shaobo
AU  - Zhang S
FAU - Lopez-Beltran, Antonio
AU  - Lopez-Beltran A
FAU - Shah, Rajal B
AU  - Shah RB
FAU - Montironi, Rodolfo
AU  - Montironi R
FAU - Tan, Puay-Hoon
AU  - Tan PH
FAU - Wang, Mingsheng
AU  - Wang M
FAU - Baldridge, Lee Ann
AU  - Baldridge LA
FAU - MacLennan, Gregory T
AU  - MacLennan GT
FAU - Cheng, Liang
AU  - Cheng L
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Surg Pathol
JT  - The American journal of surgical pathology
JID - 7707904
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (DNA, Neoplasm)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomarkers, Tumor/metabolism
MH  - Carcinoma/genetics/metabolism/*secondary
MH  - Carcinoma in Situ/genetics/metabolism/*pathology
MH  - Chemotherapy, Adjuvant
MH  - Cystectomy
MH  - DNA, Neoplasm/analysis
MH  - Female
MH  - Humans
MH  - Immunohistochemistry
MH  - In Situ Hybridization
MH  - In Situ Hybridization, Fluorescence
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Urinary Bladder Neoplasms/genetics/metabolism/*pathology
EDAT- 2011/03/09 06:00
MHDA- 2011/05/13 06:00
CRDT- 2011/03/09 06:00
PHST- 2011/03/09 06:00 [entrez]
PHST- 2011/03/09 06:00 [pubmed]
PHST- 2011/05/13 06:00 [medline]
AID - 10.1097/PAS.0b013e31820f709e [doi]
PST - ppublish
SO  - Am J Surg Pathol. 2011 Apr;35(4):474-83. doi: 10.1097/PAS.0b013e31820f709e.