Paraganglioma of the urinary bladder: Immunohistochemical, ultrastructural, and DNA flow cytometric studies

David J. Grignon, Jae Y. Ro, Bruce Mackay, Nelson G. Ordóñez, Adel El-Naggar, Alberto G. Ayala

Research output: Contribution to journalArticlepeer-review

65 Scopus citations


Primary paraganglioma arises infrequently in the urinary bladder. We present the clinicopathologic, immunohistochemical, ultrastructural, and DNA flow cytometric findings in three cases (one man and two woment). Ages at diagnosis were 19, 35, and 45 years. One female presented with paroxysmal headaches and hypertension that followed urination; the remaining two patients presented with hematuria. Immunohistochemical studies revealed positive reactivity for chromogranin (three patients), met-enkephalin (three), leuenkephalin (three), vasoactive intestinal polypeptide (two), serotonin (one), and S-100 protein (one; sustentacular cells only). Neurosecretory granules were identified in all cases; in the patient with hypertension, the granules were small with eccentric cores similar to those of adrenal pheochromocytomas. A nondiploid DNA flow cytometric pattern was present in all three patients, an aneuploid pattern was present in two, and a tetraploid pattern was present in one. After diagnosis, one patient was alive without progression at 7 years, one died of an uncertain cause at 5 years, and one suffered multiple recurrences over a 24-year period before developing metastatic disease. While the presence of aneuploidy has been shown to be a predictor of malignant behavior in adrenal pheochromocytomas, our study illustrates that DNA ploidy cannot be used as a diagnostic criterion for malignancy in urinary bladder paraganglioma.

Original languageEnglish (US)
Pages (from-to)1162-1169
Number of pages8
JournalHuman Pathology
Issue number11
StatePublished - Nov 1991


  • flow cytometry
  • immunohistochemistry
  • paraganglioma
  • ultrastructure
  • urinary bladder

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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