RCPA Examinations in Anatomical pathology - Questions ... - Rcpa.tv

Case 13: Male 65 – tumour at the
base of urinary bladder
• MICROSCOPIC
• There are multiple fragments of adenocarcinoma present. There is crush
artefact. The carcinoma has a papillary and glandular pattern. The
glandular and papillary structures are lined by columnar to pseudostratified
columnar epithelium. Mitoses are numerous. No prostatic tissue can be
identified. There is a fragment of smooth muscle and fibrous tissue
consistent with bladder wall.
• Comment
• There is an adenocarcinoma present. At the base of the bladder this is
more likely to represent a prostatic adenocarcinoma rather than a primary
bladder adenocarcinoma. Immunoperoxidase stains for PSA and PAP would
be performed. As the morphology of the tumour favours a prostatic ductal
adenocarcinoma these would be expected to be positive to confirm the
diagnosis. If the PSA and PAP are negative investigations to exclude the
possibility of a metastatic adenocarcinoma (eg CEA) will be undertaken.
• SUMMARY
• Bladder: Large duct carcinoma of prostate