Abstract
Background: Transitional cell caricinoma (TCC) with gland-like lumina is an uncommon urothelial tumor, and has long been considered to be clinico-pathologically insignificant. We report a case of TCC with florid gland-like lumina associated with frequent apoptosis, and discuss the reason why the patient showed poor clinical course.
Case: A 71-year-old man had non-papillary urothelial tumors in the bladder and in the lower half of the renal pelvis. Histologically, the bladder tumor showed high grade TCC with frequent gland-like lumina accompanied by a frequent apoptosis. The pelvic tumor also revealed high grade TCC with less frequent gland-like lumina and apoptotic bodies than the bladder tumor. The frequency of apoptosis was in parallel to the mitotic rate. Almost all the resected regional lymph nodes were had metastasis from the renal pelvic carcinoma. Urinary cytology revealed unique features characterized by smooth margin of nucleus, intracytoplasmic vacuole, and eccentric nucleus. The patient died of the carcinomas only eight months after the last operation.
Conclusion: From the study of this case, we proposed that this sort of urothelial tumor with frequent apoptoses may be a distinct aggressive subtype of TCC.
