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目的探讨膀胱浆细胞样变异型尿路上皮癌的临床病理特征、诊断及不同分子质量细胞角蛋白的表达模式。方法运用光镜、特殊染色及免疫组化染色对1例罕见的浆细胞样变异型尿路上皮癌进行观察并复习文献。结果瘤细胞弥漫分布呈浆细胞样特征,细胞胞质透亮或嗜酸性,核增大、偏位、深染。瘤细胞弥漫浸润黏膜固有层及浅肌层,可见伴随的低级别非浸润性尿路上皮癌成分。特殊染色:瘤细胞AB/PAS(+)。免疫组化:CK20和CK7(),CK5/6(-/+),CK8/18、CK18、CEA、CD138、EMA和AE1/AE3(+),E-cadherin、p63、CD38、LCA和vimentin(-)。结论浆细胞样变异型尿路上皮癌罕见,其不同分子质量角蛋白的表达存在差异,因其具有浆细胞样特征需与其他肿瘤相鉴别。
Objective To investigate the clinicopathological features, diagnosis and cytokeratin expression patterns of bladder plasmacytoid variant of urothelial carcinoma. Methods A rare case of plasma cell-like variant urothelial carcinoma was observed by light microscopy, special staining and immunohistochemistry. Results The diffuse distribution of tumor cells showed plasmacytoid features, the cytoplasm of translucent or eosinophilic, nuclear enlargement, deviation, deep staining. Diffuse infiltration of tumor cells mucosal lamina propria and superficial muscle layer, with the accompanying low-grade non-invasive urothelial carcinoma components. Special staining: tumor cells AB / PAS (+). Immunohistochemistry: CK20 and CK7 (), CK5 / 6 (- / +), CK8 / 18, CK18, CEA, CD138, EMA and AE1 / AE3 (+), E-cadherin, p63, CD38, LCA and vimentin -). Conclusion The plasmacytoid variant of urothelial carcinoma is rare. The expression of different molecular mass keratins is different. Because of its plasmacytoid features, it needs to be differentiated from other tumors.