Case of the Week: Shamrock
High cellularity sample with a neoplastic epithelial cell population.
Individual epithelial cells with rounded cytoplasmic inclusions, often appearing pink and displacing the nuclei.
Interpretation: Epithelial neoplasm; probable urothelial carcinoma (TCC).
What is unique about this case? This mass had no known association with the bladder, but when the clinical pathologist saw the cytoplasmic inclusions, a feature unique to urothelial cells, he was able to contact the clinician via Scopioâ€™s chat feature to suggest imaging of the bladder and expedite clinical planning.
What are those inclusions? Melamed-Wolinska bodies are intracytoplasmic inclusions that can be seen in the urothelial/transitional cells that line the bladder, ureters, and urethra. These were first described in human urine sediment examination in 1961. The following reference provides a brief description, background, and images: Ayra P, Khalbuss WE, Monaco SE, Pantanowitz L. Melamedâ€Wolinska bodies. Diagnostic Cytopathology, Vol 40, No 2., 2011.
What is urothelial carcinoma (TCC)? Transitional cell carcinoma, now commonly referred to as urothelial cell carcinoma, is a cancer originating from urothelial cells, often at the trigone of the bladder. Scottish Terriers have a known breed predisposition, but this tumor type can occur in any breed. Interestingly, UCC/TCC can metastasize to remote cutaneous sites. When this occurs, Melamed-Wolinska bodies give the pathologist an indication that there may be primary bladder tumor. Further information regarding transitional/urothelial cell carcinomas in dogs and humans can be found in this helpful online resource provided by Purdueâ€™s Comparative Oncology Program.
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