Journal ArticleDOI
Diagnostic utility of antibody to smoothelin in the distinction of muscularis propria from muscularis mucosae of the urinary bladder: a potential ancillary tool in the pathologic staging of invasive urothelial carcinoma.
Gladell P. Paner,Steven S. Shen,Shawn Lapetino,Girish Venkataraman,Güliz A. Barkan,Marcus L. Quek,Jae Y. Ro,Mahul B. Amin +7 more
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TLDR
The relatively distinct immunohistochemical staining pattern of smoothelin between MP and MM (including its hyperplastic forms) makes it a robust and attractive marker to be incorporated in the contemporary diagnostic armamentarium for the sometimes difficult area of staging bladder urothelial carcinoma.Abstract:
Accurate recognition of urinary bladder muscularis propria (MP) invasion by urothelial carcinoma is crucial as it is the critical crossroad between conservative and aggressive management for the patient. It is now widely known that an inconsistent layer of muscularis mucosae (MM) muscle exists in the lamina propria, which can mimic the MP muscle, particularly when hyperplastic, making staging extremely challenging in some limited, unoriented, or highly cauterized specimens. Smoothelin is a novel smooth muscle-specific contractile protein expressed only by fully differentiated smooth muscle cells, and not by proliferative or noncontractile smooth muscle cells and myofibroblasts. We performed immunohistochemical staining in the bladder for smoothelin to: (a) evaluate its expression in MM and MP muscle in cystectomy specimens and by comparing the staining pattern with smooth muscle actin (SMA), (b) study MP variations in the bladder trigone and at the ureteric insertion in the bladder wall, and (c) assess the staining pattern of MM and MP in a representative group of transurethral resection of bladder tumor specimens. In contrast to SMA, which equitably stained both types of muscle fibers, smoothelin displayed striking differential immunoreactivity between MM and MP muscle. With smoothelin, the MM muscle (including hyperplastic forms) typically showed absent (19/42, 45%) or weak and focal (18/42, 43%) staining, whereas the MP muscle typically showed strong and diffuse staining (36/42, 86%). Smoothelin accentuated individual muscle fibers within groups of MP bundles only, a feature which was evident in both MM and MP stained by SMA. When only strong and diffuse immunoreactivity in muscle was set as a threshold for positivity, 100% specificity and positive predictive value of smoothelin for MP (vs. MM) was achieved in our study. Smoothelin staining confirmed the morphologic variations in MP muscle in the bladder wall of the trigone and at the ureteric insertion. In addition to the well-defined muscle layers of MM and MP, SMA staining revealed a continuous band of ill-defined haphazardly oriented compact spindle cells that were immediately subjacent to the urothelium in all cases. These spindle cells blended with the morphologically recognizable thin slender fascicles of the MM muscle. We designate this hitherto uncharacterized thin layer of SMA-positive [muscle-specific actin positive (6/6), Masson trichrome stain predominantly blue (5/6)] and smoothelin-negative cells as suburothelial band of myofibroblasts. In all 10 transurethral resection of bladder tumor sections, smoothelin staining was in agreement with the routine light microscopic presence and absence of MP muscle. In conclusion, the relatively distinct immunohistochemical staining pattern of smoothelin between MP and MM (including its hyperplastic forms) makes it a robust and attractive marker to be incorporated in the contemporary diagnostic armamentarium for the sometimes difficult area of staging bladder urothelial carcinoma.read more
Citations
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Journal ArticleDOI
Best practices recommendations in the application of immunohistochemistry in the kidney tumors: report from the International Society of Urologic Pathology consensus conference.
Mahul B. Amin,Jonathan I. Epstein,Thomas M. Ulbright,Peter A. Humphrey,Lars Egevad,Rodolfo Montironi,David J. Grignon,K Trpkov,Antonio Lopez-Beltran,Ming Zhou,Pedram Argani,B. Delahunt,Daniel M. Berney,John R. Srigley,Satish K. Tickoo,Victor E. Reuter +15 more
TL;DR: This Special Article summarizes the overall recommendations made by the four working groups and is anticipated that this ISUP effort will be valuable to the entire practicing community in the appropriate use of IHC in diagnostic urologic pathology.
Journal ArticleDOI
Single-cell analysis uncovers fibroblast heterogeneity and criteria for fibroblast and mural cell identification and discrimination.
Lars Muhl,Guillem Genové,Stefanos Leptidis,Jianping Liu,Liqun He,Liqun He,Giuseppe Mocci,Ying Sun,Sonja Gustafsson,Byambajav Buyandelger,Indira V. Chivukula,Åsa Segerstolpe,Åsa Segerstolpe,Elisabeth Raschperger,Emil M. Hansson,Johan Björkegren,Johan Björkegren,Xiao-Rong Peng,Michael Vanlandewijck,Michael Vanlandewijck,Urban Lendahl,Christer Betsholtz,Christer Betsholtz +22 more
TL;DR: Using single-cell RNA sequencing and tissue imaging, the authors provide a molecular basis for cell type classification and reveal inter- and intra-organ diversity of these cell types.
Journal ArticleDOI
Lamina propria: The functional center of the bladder?
TL;DR: The bladder mucosa consists of the urothelium, basement membrane, and lamina propria, and the LP, which is composed of an extracellular matrix containing several types of cells, including fibroblasts, adipocytes, interstitial cells, and afferent and efferent nerve endings.
Journal ArticleDOI
A Contemporary Update on Pathology Standards for Bladder Cancer: Transurethral Resection and Radical Cystectomy Specimens
Donna E. Hansel,Mahul B. Amin,Eva Compérat,Richard J. Cote,Ruth Knüchel,Rodolfo Montironi,Victor E. Reuter,Mark S. Soloway,Saleem A. Umar,Theodorus van der Kwast +9 more
TL;DR: Ongoing international collaborations amongst pathologists have led to emerging standards in the reporting and microscopic diagnosis of BCa specimens, and the most up-to-date data and guidelines relevant to neoplastic pathology of the urinary bladder are presented.
Book ChapterDOI
Neoplasms of the urinary bladder
TL;DR: The classification system of urinary bladder neoplasia used in this chapter has been modified according to the 2016 World Health Organization (WHO) classification of tumors of the urinary system.
References
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Book
AJCC Cancer Staging Manual
Mahul B. Amin,Stephen B. Edge,Frederick L. Greene,David R. Byrd,Robert K. Brookland,Mary Kay Washington,Jeffrey E. Gershenwald,Carolyn C. Compton,Kenneth R. Hess,Daniel C. Sullivan,J. Milburn Jessup,James D. Brierley,Lauri E. Gaspar,Richard L. Schilsky,Charles M. Balch,David P. Winchester,Elliot A. Asare,Martin Madera,Donna M. Gress,Laura R. Meyer +19 more
TL;DR: Purposes and Principles of Cancer Staging and End-Results Reporting are explained.
Journal ArticleDOI
Gap junctions and connexin expression in human suburothelial interstitial cells.
TL;DR: To determine whether suburothelial interstitial cells of the human bladder express gap junctions, and if so, to establish their extent and composition, using immunocytochemistry, confocal microscopy and electron microscopy.
Journal ArticleDOI
Smoothelin, a novel cytoskeletal protein specific for smooth muscle cells
TL;DR: It is concluded that smoothelin is a new cytoskeletal protein that is only found in contractile smooth muscle cells and does not belong to one of the classes of structural proteins presently known.
Journal ArticleDOI
The role of the human bladder lamina propria myofibroblast.
TL;DR: To describe the ultrastructure and relationship to nerves of the myofibroblast in the human bladder lamina propria, and discuss its possible role in bladder function, including sensing stretch, as the response of the bladder to stretch has been thoroughly investigated.
Journal ArticleDOI
Muscularis mucosa of urinary bladder. Importance for staging and treatment.
TL;DR: Since prognosis and management of muscle invasive carcinomas (stage B) is different from that of lamina propria-invasive tumors (stage A), pathologists and urologists should be aware of the presence of a muscularis mucosa in the urinary bladder.
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