Metastatic Urothelial Carcinomas with high serum level of CA19-9. apropos of three cases

Metastatic Urothelial Carcinomas with high serum level of CA19-9. apropos of three cases

Dionisios Aninos, Christina Kaprilian, Christos Kroupis, Niki Asimaki, Andreas C Lazaris, Georgia-Eleni Thomopoulou

Abstract


CA 19-9 immunoexpression in cytological material, as shown by few case reports in   the literature, may have a diagnostic significance in urothelial carcinoma, especially in cases of metastatic disease with unknown primary.

 In the present paper, we present three cases of metastatic urothelial carcinoma with elevated CA 19-9 serum levels. The lesions were located in the lung, ascitic fluid and the skin of the right inguinal region. Paracentesis was done and ThinPrep smears were prepared for cytological diagnostic purposes. For immunocytochemical investigation, antibodies against cytokeratins 7 and 20 and GATA binding protein 3 (GATA-3) were included as well as the monoclonal antibody against CA19-9.

Morphological and immunocytochemical examination (positivity for CK7, GATA-3 and/or CK20), revealed the urothelial origin in these three cases. ABC-peroxidase staining also showed the presence of  CA 19-9 in some tumor cells.

Metastatic urothelial carcinoma may express CA19-9, as detected immunocytochemically in our cases, and may also cause elevation of CA19-9 serum levels.


Keywords


Metastatic Urothelial Carcinoma, Carbohydrate Antigen 19-9 (CA 19-9) GATA binding protein 3 ( GATA 3)

Full Text:

Read as PDF

References


.Babaian RJ, Johnson DE, Llamas L, Ayala AG

Metastases from transitional cell carcinoma of urinary bladder

Urology. 1980 Aug;16(2):142-4.

.Brown FM. Urine cytology. Is it still the gold standard for screening? Urol Clin N Am

;27:25-37.

.Ramakumar S, Bhuijan J, Besse JA, Roberts SG, Wollan PC, Blute ML et al.

Comparison of screening methods in the detection of bladder cancer. J Urol 1999;

:388-394.

. Dey P, Amir T, Jogai S, Al Jussar A.

Fine -needle aspiration cytology of metastatic transitional cell carcinoma.

Diagn Cytopathol. 2005 Apr; 32(4):226-8.

. Gruver AM, Amin MB, Luthringer DJ, Westfall D, Arora K, Farver CF et al. Selective immunohistochemical markers to distinguish between metastatic high grade urothelial carcinoma and primary poorly differentiated invasive squamous cell carcinoma of the lung. Arch Pathol Lab Med. 2012 Nov;136(11):1339-46.

. Chu P, Wu E, Weiss LM. Cytokeratin 7 and Cytokeratin 20 expression in epithelial neoplasms: a survey of 435 cases. Mod Pathol. 2000 Sep;13(9):962-72

. Dabs DJ, Abendroth CS, Grenko RT, Wang X, Radcliffe GE. Immunocytochemistry on the Thin Prep preocessor. Diagn Cytopathol. 1997 Nov;17(5):388-92.

. Koprowski H, Steplewski Z, Mitchell K, Herlyn M, Herlyn D, Fuhrer P . Colorectal carcinoma antigen detected by hybridoma antibodies. Somat Cell Mol Genet 1979;5:957-972.

. Sashide K, Isobe H, Wakumoto Y, Hanazawa K, Fujita K, Fujime M. CA 19-9 as a tumor marker for poor prognosis in urothelial carcinoma. Urol Int 2004.

. Mahander Pall, Javid Iqbal, Shrawan Kumar Singh and Satya Vati Rana. CA19-9 as a serum marker in urothelial carcinoma.

Urol Ann. 2012 May-Aug;4(2):98-101.

.Otto T, Goepel M, Heider KH, H. Rübben . Prognostic factors for bladder cancer. Urol Res 1995;23:137-141.

. Liou LS. Urothelial cancer biomarkers for recurrence and surveillance. Urology 2006;67:25-33.

. Spruck CH 3rd, Ohneseit PF, Gonzalez-Zulueta M, Esrig D, Miyao N, Tsai YC et al L. Two molecular pathways to transitional cell carcinoma of the bladder. Cancer Res. 1994 Feb 1;54(3):784-8.

. Inai H, Shimazui T, Yamamoto T, Yamauchi A, Uchida K, Takeshima H et al.

A case of transitional cell carcinoma of the urinary bladder with high serum level of CEA and CA 19-9. Acta Urol Jpn 2001;47:583-586.

. Paner GP, Annaiah C, Gulman C. Immunohistochemical evaluation of novel and traditional markers associated with urothelial differentiation in a spectrum of variants of urothelial carcinoma of the urinary bladder .Hum Pathol 2014 45 (7) 1473-82.

. Wadha N, Diwaker P, Lotha N, Arora VK, Singh N. Cytokeratin 20 immunohistochemistry on urine sediments: A potential low- cost adjunct to cytology in the diagnosis of low-grade urothelial carcinoma. Cytopathology . 2017 Dec; 28 (6):531-535.doi: 10.1111/cyt.12463. Epub 2017 Sep 22.

. Miettinen M, McCue PA, Sarlomo-Rikala M, Rys J, Czapiewski P, Wazny K et al. GATA-3: A multispecific but potentially useful marker in surgical pathology: a systematic analysis of 2500 epithelial and non epithelial tumors. Am J Surg Pathol. 2014 Jan ;38 (1): 13-22.

. Chang A, Amin A, Gabrielson E, Illei P, Roden RB, Sharma R et al.

Utility of GATA-3 immunohistochemistry in differentiating urothelial carcinoma from prostate adenocarcinoma and squamous cell carcinomas of the uterine cervix, anus and lung. Am J Surg Pathol. 2012 Oct;36(10):1472-6. doi: 10.1097/PAS.0b013e318260cde7.[19]. Innoue S, Mizushima T, Fujita K, Meliti A, Ide H, Yamaguchi S et al. GATA-3 immunohistochemistry in urothelial carcinoma of the upper urinary tract as an urothelial marker and prognosticator. Human Pathol 2017Jun;64:83-90.

. Mohamed KH, Siddiqui MT, Cohen C. GATA-3 immunohistochemical expression in invasive urothelial carcinoma. Urol Oncol 2016 Oct; 34(10):432.e9-432.e13.

.Langkilde NC, Hastrup J, Olsen S, , Wolf H, Orntoft TF. Immunohistochemistry and cytochemistry of experimental rat bladder cancer: bibding of the lectins PNA and WGA and of Le(Y) mouse monoclonal antibody. J Urol 1989;141:981-986.

.Casetta G, Piana P, Cavallini A, Vottero M, Tizzani A.. Urinary levels of tumor-associated antigens (CA 19-9, TPA and CEA) in patients with neoplastic and non-neoplastic urothelial abnormalities. Br J Urol 1993;72:60-64.

.Margel D, Tal R, Baniel J. Serum tumor markers may predict overall and disease specific survival in patients with clinically organ confined invasive bladder cancer. J Urol 2007;178:2297-2301.

.Chuang CK, Liao SK. Evaluation of CA 19-9 as a tumor marker in urothelial malignancy. Scand J Urol Nephrol 2004;38:359-365.

.Camain JY, Hammel P, Cazals-Hatem D, , Levy P, Belghiti J, Ruszniewski P. Metastatic transitional cell carcinoma with high CA 19.9 serum levels. Gastroenterol Clin Biol 2007;31:102-105.

.Kuroda N, Hayashi Y, Nishida Y, Itoh H. Combined small and transitional cell carcinoma of the urinary bladder with CA 19-9 production. Pathol Int 1999;49:462-467.


Refbacks

  • There are currently no refbacks.



Copyright 2015-2017, Hellenic Society of Pathology
ISSN: 2459-3443