Primary adenocarcinoma is rare: approximately 2% of all primary urothelial tumors.

Adenocarcinoma – voided urine

• Clusters of cuboidal or columnar cells
• Large, irregular and hyperchromatic nuclei
• Vacuolated cytoplasm
• The vacuole is often large, single and pushes the nucleus towards the cell periphery
• The nuclei tend to be vesicular
• Large nucleoli and dense chromatin strands
• Mucin-secreting, signet-ring cell and clear cell adenocarcinomas can also be seen

Adenocarcinoma – bladder washings

• Large variations in nuclear size
• Large nuclei without cytoplasm
• Nuclei with irregular shape and bizarre nucleoli
• Usually hyperchromatic nuclei with clumped chromatin but hypochromatic nuclei can also be seen
• Marked increasing of the nuclear-cytoplasmic ratio
• Dissociated tumour cells

Urinary adenocarcinoma image library