Abstract
Nephrogenic metaplasia or nephrogenic adenoma of the urinary tract may present a diagnostic challenge in surgical pathology practice. Previous case reports suggest the possibility of nephrogenic metaplasia progressing to clear cell adenocarcinoma, but a malignant potential of nephrogenic metaplasia is generally not acknowledged. A case of a 70-year-old female patient with multiple recurrences of nephrogenic metaplasia of the urinary bladder and subsequent development of clear cell adenocarcinoma is described. Immunohistochemical studies help to differentiate the 2 entities. Results of molecular studies, particularly comparative genomic hybridization analysis, suggest clonal evolution of nephrogenic metaplasia to clear cell adenocarcinoma in this case.
MeSH terms
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Adenocarcinoma, Clear Cell / genetics
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Adenocarcinoma, Clear Cell / metabolism
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Adenocarcinoma, Clear Cell / pathology*
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Adenoma / genetics
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Adenoma / metabolism
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Adenoma / pathology*
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Aged
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Biomarkers, Tumor / metabolism
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Clone Cells
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Cystectomy
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DNA, Neoplasm / analysis
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Disease Progression
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Disease-Free Survival
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Female
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Humans
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Loss of Heterozygosity
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Metaplasia / genetics
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Metaplasia / metabolism
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Metaplasia / pathology
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Neoplasm Recurrence, Local
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Nucleic Acid Hybridization
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Precancerous Conditions / genetics
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Precancerous Conditions / metabolism
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Precancerous Conditions / pathology*
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Urethra / surgery
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Urinary Bladder / pathology*
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Urinary Bladder Neoplasms / genetics
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Urinary Bladder Neoplasms / metabolism
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Urinary Bladder Neoplasms / pathology*
Substances
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Biomarkers, Tumor
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DNA, Neoplasm