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%.
|Origin||# of cases||Cercariform cells||Pearls||Cannibalism||MWB|