ECP 2022 Abstract Book
Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 nodular lesions in the penile shaft, the patient underwent radi- cal penectomy. Results: Macroscopically, the entirety of the corpora caver- nosa were occupied by a tumour that infiltrated the glans but spared the urethra. Histologic examination showed it was com- posed of large and complex glands lined by tall pseudostrati- fied columnar cells; moderate nuclear atypia with proeminent nucleoli was seen. Immunohistochemistry studies showed posi- tivity for NKX3 and negativity for cytokeratins 7 and 20, PSA and GATA3. Given the clinical history and these histologic findings, a diagnosis of metastatic ductal adenocarcinoma of the prostate was made. Conclusion: The prostate is the most common site of origin of secondary tumours of the penis, presenting ductal features in most cases. Our patient had a previous biopsy diagnosis of acinar adenocarcinoma, which showed foci of intraductal carcinoma; however, he was not submitted to radical prostatectomy hence we are not aware of the extent of the morphological spectrum that composes the primary tumour. Nevertheless, immunohistochemical analysis is essential in these cases to rule out urethral urothelial carcinomas, a histological pitfall. E-PS-24-045 Lobular breast carcinoma metastasis to the urinary bladder mimicking plasmacytoid variant of urothelial carcinoma A.M. Gonçalves Pereira*, F. Galante Pereira, C. Padrão, J. Tinoco, R. Veiga *Hospital Professor Doutor Fernando, Portugal Background & objectives: Very few cases of breast cancer metastasis to the bladder are reported in the literature. With 13 recognized variants, urothelial carcinoma can be easily mimicked by metastasis, so a high level of suspicion is needed to avoid pitfalls. Methods: A 67-year-old woman with history of mixed lobular and ductal breast carcinoma, in 2006, with multiples relapses over the years, presented to our institution with haematuria. Diagnostic exams showed, right uretero-hydronephrosis. Cystectomy showed a bladder lesion which was resected. Results: Multiple fragments of tissue were analysed, which revealed, upon histologic examination, a diffuse infiltration of the submucosa and detrusor muscle of cords, solid sheets, and singly dispersed neoplastic cells, with eccentric hyperchromatic nuclei and dense eosinophilic cytoplasm, sometimes univacuolated. No evidence of urothelial carcinoma-in-situ was found. Immunohis- tochemistry showed positivity for pan-cytokeratin’s AE1/AE3 and CAM5.2, while p40 was negative. GATA-3 was also positive. With the known history of breast cancer, oestrogen and progesterone receptors were performed, which were diffusely positive, thus proving the breast origin of the lesion. Bloodborne metastasis to the bladder are exceedingly rare and breast cancer represents a small minority of those. Conclusion: This case encompasses an insidious metastasis pattern of lobular breast carcinoma and how it can overlap morphologically and immunohistochemically (GATA3+) with the plasmacytoid variant of urothelial carcinoma. This case- report shows that a high level of suspicion and a careful clini- cal investigation are essential to avoid misdiagnosis and adds to the few cases reported of breast cancer metastasis to the bladder. The patient recovered from her urinary symptoms but died from advanced metastatic breast cancer one month after this diagnosis. E-PS-24-046 Morphological findings in paediatric heminephrectomy speci- mens – the pathological and MRI study K. Buczkowski, D. Swietoń, M. Grzywinska, P. Czarniak, A. Golebiewski, A. Durawa, E. Izycka-Swieszewska* *Medical University of Gdansk, Copernicus Hospital, Gdansk, Poland Background & objectives: The aim of this study was histopathologi- cal evaluation of renal dysplasia and other changes in heminephrectomy specimens from the children with malformations or urodynamic disor- ders, in context of clinical and modern radiological imaging (Hydro- MRI, Urography MRI). Methods: The material: 24 heminephrectomy cases (16 girls, 8 boys; age 8 months -18 years), operated due to renal duplication, vesicoureteral reflux, ectopic ureter, hydronephrosis or afunctional renal pole. Multiple sections stained H-E and Masson trichrome were examined for the presence and degree of dysplasia, severity of inflammation, fibrosis, areas of cartilage, arteriolosclerosis, and dysmorphic vessels. Uro-MRI own scale analysis. Results: Pathologically the presence of renal dysplasia was observed in 20 out of 24 cases, while radiological changes- in 17 cases. In four cases dysplasia was classified as segmental and in the remaining 16 as focal. The percentage of area covered by dys- plasia varied from 2 to 100%. Small multiple cysts were found in 8 cases. All cases with renal dysplasia showed chronic pyelonephritis with lymphoid follicle formation. The degree of renal parenchymal fibrosis varied from minimal to severe. Areas of increased fibrosis were usually accompanied by intense chronic inflammation, more advanced arteriolosclerosis, and glomerular sclerosis. Cartilage foci were identified in three cases. Conclusion: Renal dysplasia is a quite common finding in the paediatric chronic kidney disease connected to the urinary tract malformations such as vesicoureteral reflux, ureteral atresia, or duplication of the kidney. The percentage of renal parenchyma affected by dysplasia may be low, especially in kidneys with hydronephrosis, where renal dysplasia can be undetectable radiologically. E-PS-24-047 Primary prostatic leiomyosarcoma: a rare misleading tumour A. Baccouche*, S. Moussa, W. Majdoub, S. Mestiri, S. Ben Cheikh, A. Bdioui, O. Belkacem, S. Hmissa *Pathology Department, Sahloul University Hospital of Sousse, Tunisia Background & objectives: Primary prostatic leiomysarcoma is an extremely rare malignancy that accounts for only 0.1% of all primary prostatic neoplasms. Clinical presentation is not specific mimicking other prostatic disorders. We aim to analyse the clinical and pathological aspects of this rare entity. Methods: We present a case of primary prostatic leiomyosarcoma in a 64 year old man, without pathological past history. This case was diagnosed in our institution in 2019. Results: Patient presented at the urology consultation with lower urinary tract symptoms related to bladder obstruction. He reported no haematuria or perineal pain. Serum prostate-specific-antigen level was normal. The diagnosis of benign prostatic hypertrophy was suspected and patient underwent prostatic transurethral resection. Histological examination showed a large necrotic sarcomatous proliferation composed of spindle-shaped cells, with elongated plump nuclei, nuclear S361
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