Complete Colonic Metaplasia of the Urinary Bladder and Ureters With Primary Signet-Ring Cell Adenocarcinoma of the Urinary Bladder: A Rare Occurrence.
Saikat Mitra, Akshara Shangloo, Milind A Bhatkule et al.
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Case in brief
A 56-year-old woman presented with six months of voiding difficulty and hematuria. After radical cystectomy with hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection, pathology identified primary signet-ring cell adenocarcinoma of the urinary bladder. The entire bladder mucosa, including the ureteric mucosa, showed complete colonic metaplasia. Immunohistochemistry showed a lower gastrointestinal-type profile, with KRT20 and CDX2 positivity.
What made this case unusual
Complete colonic metaplasia involved both the bladder and ureteric mucosa in a case with primary bladder signet-ring cell adenocarcinoma.
Diagnostic / clinical pearl
In bladder signet-ring cell adenocarcinoma, assess the extent of mucosal metaplasia and interpret KRT20 and CDX2 positivity in the context of the primary bladder diagnosis.