PMID- 30107662 OWN - NLM STAT- MEDLINE DCOM- 20181003 LR - 20231213 IS - 0529-5807 (Print) IS - 0529-5807 (Linking) VI - 47 IP - 8 DP - 2018 Aug 8 TI - [Clinicopathologic features and immunophenotype of pseudosarcomatous myofibroblastic proliferation of urinary bladder]. PG - 585-590 LID - 10.3760/cma.j.issn.0529-5807.2018.08.004 [doi] AB - Objective: To investigate the clinicopathologic features, immunohistochemical phenotypes and biological behavior of pseudosarcomatous myofibroblastic proliferation (PMP) of the urinary bladder which may be misdiagnosed as a malignant neoplasm and undergo extensive treatment. Methods: Six cases of PMP of the urinary bladder were collected from 2001 to 2016 at Beijing Tiantan Hospital, Capital Medical University. The clinicopathologic features and immunophenotypic profile were studied by histopathological and immunohistochemical investigations with clinical follow-up. At the same time, the translocation of ALK gene was detected by fluorescence in situ hybridization (FISH). Immunohistochemistry was carried out using EnVision method for the expression of AE1/AE3, vimentin, EMA, SMA, Caldesmon, Calponin, desmin, ALK, Ki-67, MyoD1, myoglobin, CD34, S-100, CD117, CK7, CK20, GATA3, p63 and CK5/6. The related literature was reviewed. Results: There were two male and four female patients, significantly more common in women. The age of the patients was 27 to 53 years, and the median age was 35 years. The main clinical symptom was painless gross hematuria, one case with dysuria, and one case showed recurrent cystitis. There was no history of surgery and trauma. Follow-up ranged from 4 months to 13 years and showed five cases without recurrence and one case with recurrence. Microscopy showed submucosal lesion with inflammatory exudate and bleeding on the surface, in some cases extending to the superficial muscles of the bladder wall. The lesion was characterized by the proliferation of plump spindle cells, which were loose or dense in arrangement. There were varying degrees of acute and chronic inflammatory cells infiltration in the myxoid matrix. Spindle cells arranged in disorder, or a dense stranding, especially abundant in the cell region. The median mitotic rate was <2/10 HPF cells, but there were no pathological mitotic figures and without nuclear atypia in most spindle cells. Spindle cells with eosinophilic cytoplasm showed long tapering cytoplasmic projections. Oval or short spindle nuclei had vacuolization with prominent nucleoli, looking like ganglionic cells. There were scarce collagen fibers, and a few spindle cells degenerated with chromatin blurred. Some areas showed a granuloma-like pattern and neutrophils within vascular cavity. Immunohistochemically, the spindle cells were diffusely positive for vimentin, SMA and caldesmon. CKpan was strongly and diffusely positive. Desmin and calponin expression was varying. Ki-67 positive cells were about 35% to 55%, but the spindle cells were negative for myoglobin, S-100, CD117, CD34, p63 and CK5/6. FISH test showed that there was no ALK isolated signal in 6 cases of PMP, and so no positive cases were found. Conclusions: PMP of the urinary bladder is a benign non-neoplastic myofibroblastic proliferative lesion. Morphology is extremely easy to be misdiagnosed as malignant tumors, and therefore more attention should be paid to avoid this misdiagnosis. FAU - Zhang, Y H AU - Zhang YH AD - Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China. FAU - Zhang, X R AU - Zhang XR FAU - Yu, J AU - Yu J FAU - Li, H L AU - Li HL LA - chi PT - Journal Article PL - China TA - Zhonghua Bing Li Xue Za Zhi JT - Zhonghua bing li xue za zhi = Chinese journal of pathology JID - 0005331 RN - 0 (Calcium-Binding Proteins) RN - 0 (Calmodulin-Binding Proteins) RN - 0 (Desmin) RN - 0 (Microfilament Proteins) RN - 0 (Vimentin) RN - EC 2.7.10.1 (ALK protein, human) RN - EC 2.7.10.1 (Anaplastic Lymphoma Kinase) RN - EC 2.7.10.1 (Proto-Oncogene Proteins c-kit) RN - EC 2.7.10.1 (Receptor Protein-Tyrosine Kinases) SB - IM MH - Adult MH - Anaplastic Lymphoma Kinase MH - Calcium-Binding Proteins/metabolism MH - Calmodulin-Binding Proteins/metabolism MH - Cell Proliferation MH - Desmin/metabolism MH - Diagnosis, Differential MH - Female MH - Fibroma/metabolism/pathology MH - Humans MH - Immunohistochemistry MH - Immunophenotyping MH - In Situ Hybridization, Fluorescence MH - Male MH - Microfilament Proteins/metabolism MH - Middle Aged MH - Myofibroblasts/metabolism/*pathology MH - Proto-Oncogene Proteins c-kit/metabolism MH - Receptor Protein-Tyrosine Kinases/genetics MH - Translocation, Genetic MH - Urinary Bladder/metabolism/*pathology MH - Urinary Bladder Diseases/genetics/metabolism/*pathology MH - Vimentin/metabolism MH - Calponins OTO - NOTNLM OT - Diagnosis, differential OT - Immunophenotyping OT - Myofibroblasts OT - Urinary bladder neoplasms EDAT- 2018/08/16 06:00 MHDA- 2018/10/04 06:00 CRDT- 2018/08/15 06:00 PHST- 2018/08/15 06:00 [entrez] PHST- 2018/08/16 06:00 [pubmed] PHST- 2018/10/04 06:00 [medline] AID - 10.3760/cma.j.issn.0529-5807.2018.08.004 [doi] PST - ppublish SO - Zhonghua Bing Li Xue Za Zhi. 2018 Aug 8;47(8):585-590. doi: 10.3760/cma.j.issn.0529-5807.2018.08.004.