[393] Melamed-Wolinska Bodies Are an Additional Cytological Feature of Metastatic Urothelial Carcinoma

Gillian Levy, Guoping Cai, John Orfanidis, June Koizumi, Rana S Hoda. New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY; Yale University School of Medicine, New Haven, CT

Background: Melamed-Wolinska bodies (MWB) are round and pink intracytoplasmic inclusions of unknown significance found within degenerating benign or malignant urothelial cells in Pap-stained urine specimens. MWB have previously been described in pleural fluid specimens with metastatic urothelial carcinoma (MUCa) (Acta Cytol.1997;41:995). We investigated the presence of MWB in fine needle aspiration (FNA) specimens of MUCa and studied their utility vis a vis other established MUCa cytologic characteristics.
Design: Our database was searched for all cases of MUCa diagnosed over a 21-month-period (01/2010–09/2011). In addition, carcinomas (ca) of other primary sites including colonic, 3; hepatocellular, 2; pancreatic, 6; pulmonary adenoca, 10; and pulmonary squamous cell ca, 4 were obtained as control. All Pap-stained slides (Direct Smear, ThinPrep, and Cytospin) for each case were reviewed by two pathologists for MWB and other known features of MUCa: cercariform cells, pearl formation, and cannibalism.
Results: Twenty-one cases of MUCa were studied; 9 women and 12 men with ages ranging from 57 to 90 (mean-75). In MUCa cases, 76% had cercariform cells, 67% had identifiable MWB, 24% had cannibalism, and 19% had pearl formation. MWB were present in viable and degenerating tumor cells in MUCa cases and were seen in all three forms of preparation. In 25 control cases, the frequency of these features was as follows: cannibalism, 20%; cercariform cells, 12%; MWB, 12% and pearl formation, 4%.

Cytological Features in Metastatic Urothelial Carcinoma and Carcinoma of Other Primary Sites
Origin# of casesCercariform cellsPearlsCannibalismMWB
Urothelial21164514
Colon30020
Liver20000
Pancreas60011
Lung-Adeno103121
Lung-SCC40001


Figure 1:MWB (arrows) in a Pap-stained direct smear (A) and ThinPrep (B) from two cases of MUCa.


Conclusions: In this series (1) MWB were present in two-thirds (67%) of MUCa cases. (2) In decreasing frequency, cercariform cells, MWB, cannibalism, and pearl formation were identified in MUCa. (3) While not unique to MUCa, they may be considered an additional cytological feature for this diagnosis.
Category: Cytopathology

Wednesday, March 21, 2012 1:00 PM

Poster Session VI # 86, Wednesday Afternoon

 

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