Eble JN, Sauter G., Epstein JI, Sesterhenn IA - iarc

Adenocarcinoma
A.G. Ayala
P. Tamboli
M.N. El-Bolkainy
M.P. Schoenberg
E. Oliva
D. Sidransky
P. Cairns
R. Simon
Definition
A malignant neoplasm derived from the
urothelium showing histologically pure
glandular phenotype.
Epidemiology
Bladder adenocarcinoma is an uncommon
malignant tumour accounting for
less than 2% of all the malignant urinary
bladder tumours {1192,2612}. It includes
primary bladder adenocarcinoma and
urachal carcinoma.
Clinical features
Adenocarcinoma of the urinary bladder
occurs more commonly in males than in
females at about 2.6:1, and affects adults
with a peak incidence in the sixth decade
of life {24,878,953,1192,1245,1263,1388,
1813,2832}. Haematuria is the most common
symptom followed by dysuria, but
mucusuria is rarely seen {953}.
Macroscopy
Grossly, this tumour may be exophytic,
papillary, sessile, ulcerating, or infiltrating
and may exhibit a gelatinous appearance.
Histopathology
Histologically, pure adenocarcinoma of
the bladder may show different patterns
of growth {953}. These include: enteric
(colonic) type, {953} adenocarcinoma
not otherwise specified (NOS) {953},
signet ring cell {257,952}, mucinous (colloid)
{953}, clear cell {456,2901}, hepatoid
{344}, and mixed {953}. The NOS
A
B
Fig. 2.55 Adenocarcinoma of bladder, colonic type. A In this view, the surface shows intestinal metaplastic changes that merge with the invaginating glandular elements.
B In this illustration there are multiple glands embedded in a loose stroma.
A
B
Fig. 2.56 A Signet ring cell carcinoma of bladder. The lamina propria exhibits diffuse infiltration of signet ring cells. B Adenocarcinoma. Hepatoid adenocarcinoma
of the urinary bladder showing irregular areas of conventional adenocarcinoma (H&E).
128 Tumours of the urinary system