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1:
Clear Cell Adenocarcinoma
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Comments: Clear cell adenocarcinoma of the urinary tract is an uncommon neoplasm with a predilection for female urethra (two thirds of the patients are female). Rarely, it may be seen in the bladder.
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2:
Clear Cell Adenocarcinoma
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Comments: The tumor cells are arranged in tubular structures, papillae, cysts, or diffuse sheets. This example shows a predominance of dilated papillary structures lined by hobnail cells with scant cytoplasm. Cytologic atypia is not striking.
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3:
Clear Cell Adenocarcinoma
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Comments: In this example of clear cell adenocarcinoma, the tumor cells are arranged in tubules and solid nests and have abundant clear cytoplasm. In the past, this neoplasm has been referred to as Mesonephric adenocarcinoma.
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4:
Clear Cell Adenocarcinoma
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Comments: Some cases have a prominent papillary component as seen here. The major diagnostic challenge is separation from nephrogenic metaplasia, especially in small biopsies. Metastases from clear cell carcinoma of vagina, cervix and kidney should also be excluded.
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5:
Mucinous Adenocarcinoma
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Comments: This gross photograph illustrates mucinous adenocarcinoma of the urinary bladder. The tumor has a glistening surface.
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6:
Signet Ring-Cell Adenocarcinoma
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Comments: This is an example of Urachal adenocarcinoma. The tumor cells are floating in pools of mucin singly or in small clusters. The surface urothelium is uninvolved.
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7:
Signet Ring-Cell Adenocarcinoma
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Comments: A low-power view showing pools of mucin dissecting through muscularis propria. Florid cystitis glandularis with mucin extravasation may produce a similar appearance and be mistaken for adenocarcinoma.
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9:
Signet Ring-Cell Adenocarcinoma
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Comments: Another example of signet ring-cell adenocarcinoma. This does not show mucin extravasation. The nuclei are highly pleomorphic. Such tumors may produce no discernible mass and just cause diffuse thickening of the bladder wall.
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10:
Urachal Adenocarcinoma
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Comments: This case illustrates why it is critical to include the entire urachal tract and umbilicus when performing partial or radical cystectomy for urachal adenocarcinoma. This bladder tumor extended along the urachal tract to produce ulceration around umbilicus (umbilical skin is seen at upper left).
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11:
Urachal Adenocarcinoma
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Comments: The tumor showed papillary and glandular differentiation (same case as previous image).
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