Journal of Pathology and Translational Medicine

Original Article

Histologically confirmed distant metastatic urothelial carcinoma from the urinary bladder: a retrospective review of one institution’s 20-year experience: Youngeun Yoo, Junghye Lee, Heae Surng Park, Min-Sun Cho, Sun Hee Sung, Sanghui Park, Euno Choi; J Pathol Transl Med. 2021;55(2):94-101. Published online December 3, 2020; DOI: https://doi.org/10.4132/jptm.2020.10.19

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Background
Urothelial carcinoma (UC) accounts for roughly 90% of bladder cancer, and has a high propensity for diverse differentiation. Recently, certain histologic variants of UC have been recognized to be associated with unfavorable clinical outcomes. Several UC studies have also suggested that tumor budding is a poor prognostic marker. Distant metastasis of UC after radical cystectomy is not uncommon. However, these metastatic lesions are not routinely confirmed with histology.
Methods
We investigated the histopathologic features of 13 cases of UC with biopsy-proven distant metastases, with a special emphasis on histologic variants and tumor budding.
Results
Lymph nodes (6/13, 46%) were the most common metastatic sites, followed by the lung (4/13, 31%), liver (4/13, 31%), and the adrenal gland (2/13, 15%). The histologic variants including squamous (n=1), micropapillary (n=4), and plasmacytoid (n=1) variants in five cases of UC. Most histologic variants (4/5, 80%) of primary UCs appeared in the metastatic lesions. In contrast, high-grade tumor budding was detected in six cases (46%), including one case of non-muscle invasive UC. Our study demonstrates that histologic variants are not uncommonly detected in distant metastatic UCs. Most histologic variants seen in primary UCs persist in the distant metastatic lesions. In addition, high-grade tumor budding, which occurs frequently in primary tumors, may contribute to the development of distant metastasis.
Conclusions
Therefore, assessing the presence or absence of histologic variants and tumor budding in UCs of the urinary bladder, even in non-muscle invasive UCs, may be useful to predict distant metastasis.

Citations

Citations to this article as recorded by

Do Histology and Primary Tumor Location Influence Metastatic Patterns in Bladder Cancer?
Hyung Kyu Park
Current Oncology.2023; 30(10): 9078. CrossRef

Case Report

Tumor Budding and Recurrence in Submucosal Invasive Colorectal Cancers of Favorable Histology: Case Reports of Two Early Colorectal Cancers with Advanced Recurrences: Heae Surng Park, Hee Jin Chang, Ji Won Park, Byung Chang Kim, Dae Kyung Sohn, Chang Won Hong, Ji-Yeon Baek, Sun Young Kim, Hyo Seong Choi, Jae Hwan Oh; Korean J Pathol. 2012;46(3):272-277. Published online June 22, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.3.272

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Abstract PDF

Complete resection of submucosal invasive colorectal cancer (SICC) showing favorable histology is regarded as curative. We report on two cases of SICC showing recurrence within 5 years despite complete resection. The first patient was a 68-year-old woman with well differentiated rectal adenocarcinoma invading the superficial submucosa, which recurred after 4.7 years. The second patient was a 53-year-old man with pT1N0 moderately differentiated colonic adenocarcinoma. He developed widespread tumor recurrence after 3.9 years. Retrospective pathologic review of the original tumors showed multiple foci of tumor budding at the invasive front. Immunohistochemical staining for D2-40 of deeper levels of the paraffin blocks showed rare foci of small lymphatic invasion. Tumor budding at the invasive front may be an important indicator for SICC aggressiveness or may reflect early lymphatic invasion. More aggressive pathologic examination and follow-up is required for patients with SICC showing tumor budding, even in the absence of unfavorable histologic findings.

Citations

Citations to this article as recorded by

Estudio de factores histológicos predictivos de metástasis ganglionar locorregional en adenocarcinoma colorrectal mínimamente invasivo pT1
Isidro Machado, Miriam Valera-Alberni, Fernando Martínez de Juan, José A. López-Guerrero, Alfonso García Fadrique, Julia Cruz, Carmen Martínez Lapiedra, Fernanda Maia de Alcantara, Ricardo Yaya, Jorge Campos, Carlos Fernández-Martos, Rafael Estevan
Gastroenterología y Hepatología.2016; 39(1): 1. CrossRef
Histological factors predicting loco-regional lymph node metastasis in early invasive colorectal adenocarcinoma pT1
Isidro Machado, Miriam Valera-Alberni, Fernando Martínez de Juan, José A. López-Guerrero, Alfonso García Fadrique, Julia Cruz, Carmen Martínez Lapiedra, Fernanda Maia de Alcantara, Ricardo Yaya, Jorge Campos, Carlos Fernández-Martos, Rafael Estevan
Gastroenterología y Hepatología (English Edition).2016; 39(1): 1. CrossRef
Tumor budding in the clinical management of colon and rectal cancer
Viktor H Koelzer, Inti Zlobec, Alessandro Lugli
Colorectal Cancer.2014; 3(4): 387. CrossRef

Original Article

Expression of E-cadherin and beta-catenin is Altered at Tumor Budding Sites, Whose Number is Associated with the Progression of Colorectal Carcinoma.: Tae Jung Jang; Korean J Pathol. 2009;43(6):523-527.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.523

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Abstract PDF

BACKGROUND
Tumor budding is present in the stroma at the invasive margin of colorectal carcinomas (CRC). The disintegration of cell adhesion molecules is closely related to this process. This study investigated the role of tumor budding in the progression of CRC, and compared the expression of beta-catenin and E-cadherin between tumor budding and tumor center to determine whether epithelial-to-mesenchymal transitions (EMTs) occur in tumor budding. METHODS: The number of tumor budding (NTB) instances was determined in 58 cases of CRC, and immunoreactivities of E-cadherin and beta-catenin were compared at the tumor center and at the tumor budding site. Immunohistochemical staining for vimentin was also done.
RESULTS
Tumor budding was seen in 52 tumors (90%). There were significant associations between NTB and cliniopathologic parameters such as tumor depth, nodal metastasis and clinical stage. Expression of cytoplasmic and nuclear beta-catenin were significantly higher at tumor budding sites than in the tumor center. In contrast, expression of membranous and cytoplasmic E-cadherin were significantly higher in the tumor center than at the tumor budding sites. Vimentin was expressed at tumor budding foci of only 2 cases (3%).
CONCLUSIONS
This study suggests that EMT occurs at tumor budding, and that NTB may be a good marker for predicting a poor prognosis in CRC.

Citations

Citations to this article as recorded by

E-Cadherin Expression Varies Depending on the Location within the Primary Tumor and Is Higher in Colorectal Cancer with Lymphoid Follicles
Adam R. Markowski, Konstancja Ustymowicz, Anna J. Markowska, Wiktoria Romańczyk, Katarzyna Guzińska-Ustymowicz
Cancers.2023; 15(12): 3260. CrossRef
Gland Attenuation, a Novel Morphological Feature of Colorectal Cancer: Evidence for an Epithelial-Mesenchymal Transition
Tae-Hwa Baek, Dong-Wook Kang, Joo-Heon Kim, Hyun-Jin Son
Annals of Coloproctology.2018; 34(4): 187. CrossRef
Differential membranous E-cadherin expression, cell proliferation and O-GlcNAcylation between primary and metastatic nodal lesion in colorectal cancer
Tae Jung Jang
Pathology - Research and Practice.2016; 212(2): 113. CrossRef
Differential β-catenin expression levels are associated with morphological features and prognosis of colorectal cancer
ZHAO-HUA GAO, CHONG LU, MEI-XIAN WANG, YI HAN, LI-JUAN GUO
Oncology Letters.2014; 8(5): 2069. CrossRef
C4.4A is associated with tumor budding and epithelial–mesenchymal transition of colorectal cancer
Ryota Oshiro, Hirofumi Yamamoto, Hidekazu Takahashi, Masahisa Ohtsuka, Xin Wu, Junichi Nishimura, Ichiro Takemasa, Tsunekazu Mizushima, Masataka Ikeda, Mitsugu Sekimoto, Nariaki Matsuura, Yuichiro Doki, Masaki Mori
Cancer Science.2012; 103(6): 1155. CrossRef
Assessment of tumor budding in colorectal carcinoma: Correlation with β-catenin nuclear expression
S. El-Gendi, A. Al-Gendi
Journal of the Egyptian National Cancer Institute.2011; 23(1): 1. CrossRef
Cell Surface Markers in Colorectal Cancer Prognosis
Larissa Belov, Jerry Zhou, Richard I. Christopherson
International Journal of Molecular Sciences.2010; 12(1): 78. CrossRef
Lethal Giant Larvae2 Expression Is Reduced or Localized at Cytoplasm in Colon Adenomas and Adenocarcinomas
Tae Jung Jang
The Korean Journal of Pathology.2010; 44(5): 488. CrossRef

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