small single cells with eccentric nuclei in lobules within the lamina propria Image

some extracellular mucin; some cells have a cytoplasmic vacuole Image

some staining for keratin 20 is present which is a typical feature in many signet ring adenocarcinomas of bladder; interestingly, some of these bladder tumors may stain for PSAP (but not PSA).

no staining for keratin 7; staining for this keratin is variable in this tumor

CEA is strongly positive.

mucicarmine highlights the mucin production Image

Adenocarcinomas of the bladder can be non-specific in type, or a specific type such as mucinous, enteric, or signet ring. The signet ring type may be the only component, or it may be mixed with another histological type. A metastatic lesion should be excluded.

Patients often present with hematuria, and possibly dysuria. Males predominate 2:1.

Partial or radical cystectomy followed possibly by chemotherapy or radiation therapy.

Appears to have a worse prognosis than traditional transitional cell carcinoma of bladder (Busto Martin). One study demonstrated that the extent of signet-ring differentiation was associated with worsened survival and higher stage disease (Thomas). Many patients present with stage IV disease which negatively impacts survival. Five year survival is fairly poor,and one study showed an overall survival rate at 2 years was 43% (Akamatsu).

• Bladder : Adenocarcinoma (Nonurachal)

• Bladder : Adenocarcinoma, Lobular Type

• Bladder : Adenocarcinoma, Mucinous Type