PMC3352587_01
Magnetic resonance images of the tumor. The horizontal plane of the T1-weighted image shows that the tumor involves the region surrounding the urethra
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F1
Computed tomography (CT) and magnetic resonance imaging (MRI) showed a tumor (diameter, 47 mm), which involved the urethra entirely [Figure 1].
Cystourethroscopic findings of the urethral lesion. The diverticulum made an orifice into the lumen of the ur ethra and a whitish papillary and villous tumor appeared from the orifice of the diverticulum
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F2
Whitish papillary and villous lesions were observed in both diverticula [Figure 2].
Cytological findings of the urine sediments. Papanicolaou staining, a) A papillary cluster of tumor cells. The tumor cells with hyperchromatism are piled up irregularly (1000x), b) A spherical cluster of clear cells (400x), c) Nuclei of the tumor cells showing fine to granular chromatin and prominent nucleoli (1000x)
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F3
The Papanicolaou-stained specimens showed a small number of papillary or spherical clusters of atypical cells with many benign urothelial cells and squamous cells in the background [Figure 3a and b]. The nuclei of the atypical cells showed an increase in the chromatin content with fine to granular pattern and irregular contours [Figure 3c]; the nucleoli were prominent. Most of the atypical cells had a moderate amount of cytoplasm that was lightly stained light green; however, some atypical cells showed clear, abundant cytoplasm that formed spherical clusters resembling "mirror balls" [Figure 3b].
Histological and immunohistochemical findings, a) A biopsied specimen showing a papillary lesion covered with cuboidal cells. A hobnail pattern configuration was observed without any stromal invasion. A few clear cells were also observed (inset) (H and E 200x), b) The tumor cells were positive for CD15 (H and E 200x), c) The Ki-67 labeling index was approximately 20% (H and E 100x)
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F4
TUR samples showed that the tumor comprised papillo-tubular lesions [Figure 4a]. Tucson, AZ, USA], epithelial membrane antigen (EMA) (E29, RTU prediluted, Nichirei Bioscience, Tokyo, Japan), and carbohydrate antigen (CA) 125 (M11, 1:25, Dako, Glostrup, Denmark), and were also focally positive for CD15 (80H5, RTU prediluted, Immunotech, Marseille, France) [Figure 4b]. The tumor cells were negative for CK 5/6 (D5/16 B4, 1:50, Dako), CK 20 (SP33, RTU prediluted, Ventana Medical Systems), carcinoembryonic antigen (12-140-10, RTU prediluted, Leica Microsystems, Milton Keynes, UK), thrombomodulin (1009, 1:50, Dako), uroplakin III (AU1, RTU prediluted, Nichirei Bioscience), prostate-specific antigen (polyclonal, Dako), calretinin (5A5, RTU prediluted, Leica Microsystems), estrogen receptor (6F11, 1:50, Leica Microsystems), and progesterone receptor (312, 1:50, Leica Microsystems).