{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T18:52:41Z","timestamp":1791053561038,"version":"4.1.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Virchows Arch"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The full morphologic spectrum of divergent differentiations in urothelial carcinoma is still unknown. Herein, we describe two cases of pilomatrix-like high grade carcinomas (PiMLC) involving bladder. Case #1 was a 55-year-old male with a bladder tumor with basaloid nests, geographic necrosis, and shadow cells. The tumor cells were positive for LEF1, \u03b2-catenin (nuclear\/cytoplasmic staining), CK5\/6, CD10, BerEP4, p63 (focal-to-patchy) and AMACR (patchy), and negative for CK7, GATA3, CDX2, INSM1, chromogranin, synaptophysin, p40, CK20, calponin, CD117, S100, smooth muscle actin, p16 and high-risk HPV in-situ hybridization. PD-L1 and Her2 were negative. Trop-2 immunostain showed modest expression (H-score: 75). There were rare microscopic foci of surface disease with a similar basaloid appearance that were also positive for LEF1 and negative for GATA3. Genomic profiling of the tumor revealed an\u00a0\n                    <jats:italic>APC<\/jats:italic>\n                    mutation, suggesting \u03b2-catenin\/Wnt pathway dysregulation. Additionally, mutations in\n                    <jats:italic>TERT<\/jats:italic>\n                    ,\u00a0\n                    <jats:italic>CDKN2A<\/jats:italic>\n                    , and\u00a0\n                    <jats:italic>TP53<\/jats:italic>\n                    were present.\u00a0The patient was transitioned to hospice shortly after initiating chemotherapy. Case #2 was a 78-year-old male with a large bladder mass with basaloid nests and abundant shadow cells. Conventional UC was focally present. The tumor cells were positive for p63, \u03b2-catenin (nuclear\/cytoplasmic staining), CK14 (focal), and CK20 (focal), and negative for GATA3, Uroplakin, NUT, and Her2. Genomic profiling of the tumor revealed a\u00a0\n                    <jats:italic>CTNNB1<\/jats:italic>\n                    mutation, suggesting \u03b2-catenin\/Wnt pathway dysregulation. Additionally, mutations in\n                    <jats:italic>RB1<\/jats:italic>\n                    ,\u00a0\n                    <jats:italic>KMT2A<\/jats:italic>\n                    , and\u00a0\n                    <jats:italic>TP53<\/jats:italic>\n                    were present. Overall, these two cases describe PiMLC of urinary bladder with evidence supporting novel pilomatrix-like divergent differentiation from urothelial carcinoma.\n                  <\/jats:p>","DOI":"10.1007\/s00428-026-04735-4","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:21:28Z","timestamp":1791004888000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pilomatrix-like high grade carcinomas involving urinary bladder: a novel divergent differentiation in urothelial carcinoma"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2244-2435","authenticated-orcid":false,"given":"Elaine","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1890-7424","authenticated-orcid":false,"given":"Sarah Mae","family":"Lammert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trent","family":"Davids","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8155-7131","authenticated-orcid":false,"given":"Jennifer A.","family":"Bennett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gladell P.","family":"Paner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0899-484X","authenticated-orcid":false,"given":"Peng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa Yuwono","family":"Tjota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0455-9413","authenticated-orcid":false,"given":"Tatjana","family":"Antic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arndt","family":"Hartmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas","family":"Agaimy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1793-2732","authenticated-orcid":false,"given":"Jung Woo","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,3]]},"reference":[{"issue":"1","key":"4735_CR1","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1111\/cup.13046","volume":"45","author":"C Jones","year":"2018","unstructured":"Jones C, Twoon M, Ho W, Portelli M, Robertson BF, Anderson W (2018) Pilomatrix carcinoma: 12-year experience and review of the literature. 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