Rolim I, Henriques V, Rolim N, et al. - Researchers assessed 115 cases of high-grade urothelial carcinoma of the upper urinary tract for their clinicopathologic features. Thirty-nine cases (34%) exhibited variant histology that was typically seen in high pathological stage (pT2-pT4) (82%, 32 cases) patients with lower survival rate (70%, 27 cases, median survival 31 months) and consisted in urothelial with one (23%), two (3%), and three or more variants (3%); pure variant histology was observed in 4% of cases. The most frequent variant was squamous divergent differentiation (7%) followed by sarcomatoid (6%) and glandular (4%), followed by 3% each of micropapillary, diffuse-plasmacytoid, inverted growth, clear cell glycogenic, or lipid-rich. Correlation of variant histology with pathological stage and survival status was observed. In the univariate survival analysis, variant histology was noted to be a feature of lower recurrence-free survival. In urothelial carcinoma of the upper urinary, variant histology is a feature of aggressiveness supporting the value of its reporting.