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Int J Clin Exp Pathol 2012;5(8):840-844

Case Report
Bladder carcinoma with shadow cell differentiation: a case report with
immunohistochemical analyses

Toshitsugu Nakamura

Department of Pathology, Suwa Red Cross Hospital, Suwa, Japan

Received July 29, 2012; Accepted September 6, 2012; Epub October 1, 2012; Published October 15, 2012

Abstract: A peculiar case of bladder carcinoma showing shadow cell differentiation (SCD) in a 72-year-old man is presented. The tumor
histologically revealed high grade urothelial carcinoma (UC) and partially contained squamous component with a transition to shadow cell
nests, similar to those seen in cutaneous pilomatricoma (PMX). Immunohistochemically, the modes of cell death in the component of SCD
were identical to those in PMX. The present case as well as 10 cases of cutaneous PMX showed nuclear expression of beta-catenin, whereas
10 cases of bladder UC with squamous differentiation revealed membranous localization without nuclear expression. These results suggest
that nuclear accumulation of beta-catenin may play an important role for SCD in the present case. SCD in extracutaneous tumor is extremely
rare and, in the literature, the present case is the second one as for bladder carcinoma. (IJCEP1207023).

Keywords: Bladder carcinoma, shadow cell differentiation, pilomatricoma, beta-catenin

Address all correspondence to:
Dr. Toshitsugu Nakamura, Department of Pathology, Suwa Red Cross Hospital, 5-11-50 Kogan-dori, Suwa 392-8510, Japan. Phone:
+81-266-52-6111 (ext.2304); Fax: +81-266-57-6036; E-mail: pathology@suwa.jrc.or.jp