Cytomorphology of lymphoepithelioma‐like carcinoma of the urinary bladder: Report of two cases
Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15232, USA.Diagnostic Cytopathology (Impact Factor: 1.12). 08/2008; 36(8):600-3. DOI: 10.1002/dc.20853
Lymphoepithelioma-like carcinoma (LELC) of the urinary bladder is a rare variant of high-grade urothelial carcinoma. Here, we report urine cytologic findings in two cases of this rare entity, the diagnosis of which was confirmed by histopathological examination of the resected tumors. The cytomorphologic features included large tumor cells with high nuclear to cytoplasmic ratios, vesicular chromatin, and prominent nucleoli, presented as single cells or intermixed with inflammatory cells. The differential diagnosis included otherwise typical high-grade urothelial carcinoma, reactive urothelial cells and rarely large cell lymphoma. The rarity of the tumor cells may impose a diagnostic challenge in urine specimen.
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- "A correct diagnosis on a urine cytology specimen can be particularly challenging, considering the rarity of the tumor. Cai and Parwani12 reported cytologic findings in two cases of LELC of the bladder, which were confirmed by histopathological examination of the resected tumor. Useful cytomorphologic features include the presence of large tumor cells with a high nuclear-to-cytoplasmic ratio, vesicular chromatin and prominent nucleoli, presenting as single cells or intermixed with inflammatory cells.12 "
ABSTRACT: Lymphoepithelioma-like carcinoma (LELC) is a rare malignant neoplasm in the urinary bladder, which can histologically mimic lymphoma, poorly differentiated invasive transitional cell carcinoma or poorly differentiated squamous cell carcinoma with a lymphoplasmacytic background. A urinary bladder tumor was identified in a 65-year-old man suffering from hematuria for several weeks. Transurethral biopsy revealed an undifferentiated tumor with prominent lymphocytes and plasma cell infiltration. Immunohistochemical evaluation showed positive staining for cytokeratin and epithelial membrane antigen. Subsequent radical cystectomy showed pure LELC. We present the case to highlight the significance of recognizing this unusual bladder tumor and discuss the important differential diagnosis, treatment options and prognosis.
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ABSTRACT: Lymhoepithelioma like carcinoma (LELC) is a term used for describing tumors outside nasopharynx which are histologically composed of undifferentiated malignant epithelial cells admixed with prominent lymphoid infiltrate. It is rarely seen in urinary bladder and represent %0,4-1,3 of all bladder carcinomas . Although histopathological features of urothelial carcinomas are well described, to our knowledge, features of LELC of urinary bladder has not been reported to date. Here we report a case of LELC which was seen on urine smears and discuss the cytological differential diagnosis.
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