ArticleVirchows Archiv : an international journal of pathology2026
Squamoid and glycogen-rich-like clear-cell change in low-grade papillary urothelial carcinoma: a clinicopathologic analysis.
Article in Virchows Archiv : an international journal of pathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLow-grade papillary urothelial carcinoma (LGPUC) is the most common form of non-muscle-invasive bladder cancer and is typically associated with frequent recurrence but limited progression. While focal squamoid morphology and clear-cell change may occasionally be encountered in LGPUC, their clinicopathologic significance remains poorly defined.
designWe retrospectively reviewed all LGPUC cases diagnosed at a tertiary academic center between 2015 and 2025. Hematoxylin and eosin (H&E)-stained slides were reassessed for squamoid morphology and H&E-suspected glycogen-rich-like clear-cell change. Cases with suspected glycogen-rich-like morphology underwent PAS and PASD staining for histochemical evaluation. Clinicopathologic features and clinical outcomes were analyzed.
resultsA total of 514 patients with LGPUC were included. Squamoid morphology was identified in 6 cases (1.2%). Four additional tumors (< 1%) showed focal glycogen-rich-like clear-cell change. During follow-up, recurrence occurred in 1 of 6 patients (16.7%) with squamoid morphology, whereas no progression was observed in this subgroup. One patient with glycogen-rich-like clear-cell change subsequently developed invasive low-grade urothelial carcinoma (pT1). Conventional LGPUC showed recurrence in 57 of 504 patients (11.3%) and subsequent progression in 27 of 504 patients (5.4%).
conclusionSquamoid morphology is an uncommon finding in LGPUC and was not associated with adverse clinical outcomes in this cohort. Glycogen-rich-like clear-cell change could not be definitively confirmed on corresponding deeper PAS/PASD levels, underscoring the importance of careful histochemical correlation before diagnosing glycogen-rich morphology in LGPUC. These findings suggest that focal squamoid morphology and glycogen-rich-like change should be interpreted cautiously and do not appear to justify tumor upgrading in the absence of conventional high-grade features.
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