urothelial carcinoma


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  • Clinical

    • 1-3% of prostate tumors
    • age: 45+
    • 45% in those with invasive bladder cancer, esp in those with multifocal or in situ component
    • arise from urothelium of prostatic urethra and proximal prostatic ducts

  • Histology

    • usually high grade with comedo necrosis
    • usually associated with in situ component
    • stromal desmoplasia (if invasion) or inflammation (if in situ)
    • compared to high grade prostate adenocarcinoma, urothelial carcinoma has:
      • greater pleomorphism, mitosis
      • glassy eosinophilic cytoplasm (prostate adeno is foamy and pale)
      • more prominent squamous differentiation
      • more nest (vs cords in prostate adeno)

  • Stains

    • similar to bladder: CK7 (100%), CK20(67%), p63 (81-92%), GATA3 (67-90%)
    • variable basal cell markers: 34BE12, p63
    • negative: PSA, PAP
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