nested variant of urothelial carcinoma

nested variant of urothelial carcinoma

A rare (less than 0.3% of invasive bladder tumours), deceptively bland yet clinically aggressive urothelial carcinoma, which affects older people, especially males.
 
Clinical findings
Haematuria (usually macroscopic), dysuria, frequency, nocturia. Despite NVUCs’ low-grade histology, they are bad actors which, given the typical delay in diagnosis, contributes to their more advanced local stage compared to conventional high-grade urothelial carcinoma.

Management
The optimal treatment for NVUCs is uncertain given its rarity—radical resection is recommended; chemo- and radiotherapy are completely ineffective.
 
Prognosis
Most patients die within 3 years.
References in periodicals archive ?
v) Nested variant of urothelial carcinoma of the bladder may resemble nephrogenic adenoma of the bladder but characteristically in nested variant of urothelial carcinoma there is cystic degeneration of nests and not a single layer and there is marked atypia [7].
xi) Nested variant of urothelial carcinoma (Figures 4(c) to 4(f)) exhibits distinctive patterns in the superficial and deep portions of the tumour.
Epstein, "Florid von Brunn nests mimicking urothelial carcinoma: a morphologic and immunohistochemical comparison to the nested variant of urothelial carcinoma," The American Journal of Surgical Pathology, vol.
Nest-Like Features in Bladder, Simulating the Nested Variant of Urothelial Carcinoma.
The most clinically significant differential diagnoses for pseudocarcinomatous hyperplasia include invasive high-grade urothelial carcinoma and the nested variant of urothelial carcinoma.
C, The nested variant of urothelial carcinoma is composed of bland urothelial nests; however, the nests are usually more confluent and irregular than those in pseudocarcinomatous hyperplasia.
Other pathological differential diagnoses of this lesion include intestinal metaplasia, adenocarcinoma and nested variant of urothelial carcinoma, which shows small crowded nests with infiltrative base.
However, florid von Brunn nests, the nested variant of urothelial carcinoma, and urothelial carcinoma involving von Brunn nests can mimic adenocarcinoma.
However, keeping in mind a few of their histologic characteristics can help in proper identification and distinction from the nested variant of urothelial carcinoma, which is a high-grade carcinoma with a deceptively bland cytologic appearance.
Nephrogenic adenoma with focal solid and/or tubular pattern, especially with irregular borders and involving deep lamina propria/superficial muscularis propria, (10) may mimic certain urothelial carcinomas with deceptively bland features, such as the nested variant of urothelial carcinoma, urothelial carcinoma with small tubules, and microcystic urothelial carcinoma.
The nested variant of urothelial carcinoma (Figure 2, C through F) has distinctive patterns in the superficial and deep portions of the tumor.
Although a prominent tubular histologic appearance may be noted in the nested variant of urothelial carcinoma, some urothelial carcinomas (urothelial carcinoma with small tubules) have an exclusive component of small to medium-sized tubules that mimic NA or cystitis glandularis.