Definition
Urothelial carcinoma characterized by nests of infiltrative tumor cells with bland cytologic appearance.
Clinical Features
Incidence
It comprises about 0.3% of urothelial carcinomas.
Age
It occurs between the fourth and ninth decade of age (mean age 68 years)
Sex
It is more common in male patients.
Site
It is mostly located in the urinary bladder, with involvement of the ureteral orifice and trigone, with few cases reported in renal pelvis or ureter. However, in the ureter and in the renal pelvis, von Brunn nests resemble nested carcinoma so closely that the diagnosis of pure nested cancer should not be made on biopsy in these sites (Volmar et al. 2003).
Treatment
Urothelial carcinoma, nested type is treated similarly to urothelial carcinoma in general
Outcome
The nested variant shows no difference compared with conventional urothelial carcinoma. pT categories define different survival groups. It...
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References and Further Reading
Brimo, F., Dauphin-Pierre, S., Aprikian, A., et al. (2015). Inverted urothelial carcinoma: A series of 12 cases with a wide morphologic spectrum overlapping with the large nested variant. Human Pathology, 46, 1506–1513.
Lopez-Beltran, A., Cheng, L., Montironi, R., et al. (2014). Clinicopathological characteristics and outcome of nested carcinoma of the urinary bladder. Virchows Archiv, 465, 199–205.
Lopez-Beltran, A., Henriques, V., Montironi, R., et al. (2018). Variants and new entities of bladder cancer. Histopathology, 74, 77–96.
Minghao, Z., Wei, T., Zhuge, J., et al. (2015). Distinguishing nested variants of urothelial carcinoma from benign mimickers by TERT promoter mutation. The American Journal of Surgical Pathology, 39, 127–131.
Moch, H., Cubilla, A. L., Humphrey, P. A., et al. (2016). The 2016 WHO classification of tumours of the urinary system and male genital organs – Part A: Renal, penile, and testicular tumours. European Urology, 70, 93–105.
Murphy, W. M., & Deanna, D. G. (1992). The nested variant of transitional cell carcinoma: A neoplasm resembling proliferation of Brunn’s nests. Modern Pathology, 5, 240–243.
Volmar, K. E., Chan, T. Y., De Marzo, A. M., et al. (2003). Florid von Brunn nests mimicking urothelial carcinoma: A morphologic and immunohistochemical comparison to the nested variant of urothelial carcinoma. The American Journal of Surgical Pathology, 27, 1243–1252.
Young, R. H., & Oliva, E. (1996). Transitional cell carcinomas of the urinary bladder that may be underdiagnosed. A report of four invasive cases exemplifying the homology between neoplastic and non-neoplastic transitional cell lesions. The American Journal of Surgical Pathology, 20, 1448–1454.
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Canas-Marques, R., Raspollini, M.R., Lopez-Beltran, A. (2020). Urothelial Carcinoma, Nested Type. In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_4988-1
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DOI: https://doi.org/10.1007/978-3-319-28845-1_4988-1
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