Plasmacytoid variant of urothelial carcinoma: a report of a rare case.

Plasmacytoid variant of urothelial bladder carcinoma is rare. We report a case with a detailed discussion of features that help characterize this variant. A 50-year-old man originally presented with gross hematuria. Resections at that time revealed a grade I-II superficial urothelial carcinoma. He did not return for follow-up until recently, three years later, when he presented with recurrent gross hematuria. An extensive tumor was identified on cystoscopy. Resection revealed a high-grade non-invasive papillary urothelial carcinoma. CT scan revealed a large urinary bladder solid mass with bilateral hydronephrosis. Metastatic workup was negative. The patient underwent a radical cystectomy with creation of ileal conduit. Final pathology revealed plasmacytoid variant of urothelial carcinoma with extensive vascular invasion and extension to the perivesical adipose tissue. We present a rare variant of urothelial carcinoma with comprehensive analysis of the morphological and immunophenotypic clues that characterize this variant.

Hemispheric extra-ventricular glioneurocytoma: a clinicopathological review with detailed immunohistochemical profile.

Glioneuronal tumors have recently been recognized in the WHO Classification of Tumors of the Central Nervous System, 2007 [14]. However, the entities included in this category do not encompass all the glioneuronal tumors encountered during practice. We characterize a new entity called glioneurocytoma (GNC) showing distinct morphology with glial and neuronal differentiation. We reviewed 10 cases of glioneurocytomas diagnosed in our department during 2003 and 2004, with emphasis on clinicopathological features, immunohistochemical profile, genetic aberrations and prognosis. The cases included in the study showed equal gender distribution and age range of 23-40 years and mean age of 34.4 years at the time of initial presentation. Most of the tumors were centered in the frontal lobe. In our study, GFAP was the most sensitive and relatively specific marker for glial differentiation and remains the marker of choice for glial differentiation. CD56 and S100 protein were sensitive but non-specific. Vimentin, CD57 and NF were non-contributory in the immunohistochemical work up of glioneurocytomas. We concluded that the diagnosis of glioneurocytomas requires attention to morphological details and proper immunohistochemical assessment, using a panel of both glial and neuronal markers. Particular attention is recommended to the existence of the intermediate neurocytic cells which may be unique for these tumors. Future implication with full molecular analysis for gene expression profiling is suggested for proper and accurate identifying this entity.