2021 Volume 60 Issue 6 Pages 344-352
Background : Sarcomatoid urothelial carcinoma arising from the urinary tract, especially the ureter, is very rare. We report the cytological and histological features of a case of sarcomatoid urothelial carcinoma of the right ureter, with a review of the literature.
Case : A 67-year-old man presented to his physician with gross hematuria. Abdominal CT revealed a nodular shadow in the right ureter. Right upper tract urinary cytology revealed many atypical cells, both dispersed singly as well as in aggregates. Right nephroureterectomy was performed, and histopathology of the resected specimen showed invasive urothelial carcinoma with a sarcomatoid component. Immunostaining of the cytologic and histologic specimens for GATA3 and p63 showed positive staining for both. Based on the findings, we made the final diagnosis of sarcomatoid urothelial carcinoma of the right ureter.
Conclusion : Sarcomatoid urothelial carcinoma is a group of urothelial carcinomas with a poor prognosis, that require rapid and accurate histopathological diagnosis. When a large number of isolated or aggregated atypical cells are found on urinary cytology, it is important to consider the possibility of sarcomatoid urothelial carcinoma and perform confirmatory immunohistochemistry for GATA3 and p63.
