Plasmacytoid Variant Urothelial Carcinoma of the Bladder with Different Proportion of Plasmacytoid Variant Urothelial Carcinoma Differentiation:Two Case Report and Literatures Review

Objective Plasmacytoid urothelial carcinoma (PUC) of the bladder is a recently identified rare variant of urothelial carcinoma (UC). The purpose of this study was to study the clinical, imaging and pathological characteristics of PUC. Methods We reviewed two cases of PUC with different aggressive behaviour related the proportion of Plasmacytoid variant UC differentiation. The clinical, imaging characteristics and pathological biological parameters including the express of several biomarkers of tumours detected by immunohistochemistry method and the levels of several serum tumour markers measured with Electrochemiluminescence method. Results A 74-year-old and 53-year-old Chinese male were diagnosed with high-grade PUC (pT4N2M0) by the microscopic plasmacytoid appearance of the tumor from the radical cystectomy specimen, but they had different proportion of plasmacytoid variant UC differentiation and different outcomes (8 months, 17 months, respectively). The elder had approximately ninety percent of PUC component and the younger had fifty percent of PUC component. Immunohistochemical staining in the two cases was positive for epithelial markers and weekly positive for CD138. They all lost the membranous expression of E-cadherin. The expression of Ki-67 of the elder was approximately 60%, and 30% of the younger. The microvascular density based on CD105 of the elder was about 42.23/HPL, and 13.12/ HPL of the younger. Conclusions PUC of the urinary bladder is an uncommon and aggressive variant of UC associated with late presentation and poor prognosis. The correct diagnosis of PUC of the bladder may be reached by combination of its typical histological features, clinic characteristics, and immunohistochemical results.