scholarly journals HISTOPATHOLOGICAL SPECTRUM OF UROTHELIAL LESIONS: AN OBSERVATIONAL STUDY

2020 ◽  
pp. 1-4
Author(s):  
Nishat Ahmad ◽  
Saurabh Banerjee ◽  
A K. Srivastava
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Bladder Tumour ◽  
Histopathological Analysis ◽  
Low Grade ◽  
High Grade ◽  
Urothelial Carcinomas ◽  
Neoplastic Lesions ◽  
Papillary Urothelial Carcinoma ◽  
Muscle Invasion

BACKGROUND: Urinary bladder cancer is second most common cancer after prostate cancer in the genitourinary system. Urothelial Carcinoma is the commonest tumour type accounting for 90% of all primary tumours of the bladder Histopathological analysis of cystoscopic bladder biopsy and Transurethral resection of the bladder tumour (TURBT) material are the mainstay for cancer diagnosis. This study was aimed to determine the frequency of different types of neoplastic lesions of the urinary bladder and to determine the grade and stage of urothelial tumours. MATERIAL METHOD: The study was carried out in the Department of Pathology, Rajendra Institute of Medical Sciences (RIMS), Ranchi from January 2018 to June 2020 and included 30 cases of cystoscopic biopsies and TURBT specimens. RESULTS: Out of 30 cases of neoplastic lesions, majority were of high grade papillary urothelial carcinoma (n=14, 46.67%) followed by low grade papillary urothelial carcinoma (n=9, 30%), 3 cases (10%) were of PUNLMP, 2 cases (6.66%) of papilloma and 1 (3.33%) case each of moderately differentiated squamous cell carcinoma and extra nodal NHL. The most common age group was 41-50 years and 51-60 years with 9 (30%) cases each. Muscle invasion was seen only in high grade papillary urothelial carcinomas. CONCLUSION: High-grade urothelial carcinomas with lamina propria and muscle invasion are the most common neoplastic lesion of urinary bladder with significant morbidity and mortality. Muscle invasion and grading, as per TNM staging, are valuable prognostic factors.

scholarly journals A histopathologic study of urinary bladder tumors at tertiary care center in Mid-Western region of Nepal

2018 ◽  
Vol 9 (6) ◽  
pp. 45-50
Author(s):  
Binita Goyal ◽  
Sheshagiri Rao ◽  
Rajina Sahi ◽  
Subechhya Jaiswal
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Low Grade ◽  
High Grade ◽  
Medical Sciences ◽  
Bladder Tumors ◽  
Common Cancer ◽  
Urothelial Tumors ◽  
Papillary Urothelial Carcinoma ◽  
Muscle Invasion

Background: Urinary bladder cancer is an important cause of morbidity and mortality due to urological conditions. It is tenth most common cancer overall in both sexes. It is seventh most common cancer overall and second most common cancer of genitourinary tract in males. Ninety five percent of bladder tumors are epithelial and the rest are mesenchymal, of which majority are primary urothelial tumors. Urothelial tumors are classified into infiltrating urothelial carcinoma with its variants and non-invasive urothelial neoplasias. Tumor stage is the strongest prognostic parameter.Aims and Objectives: The current study was designed with an aim to elucidate the histologic pattern of bladder tumors and observe whether any association between histologic grade and muscle invasion exists.Materials and Methods: This descriptive study was carried out on 84 cases of urinary bladder tumors received in Department of Pathology, College of Medical Sciences and Teaching Hospital during a time period of 5 years from January 2012 to December 2016.Results: The mean ± SD of age of presentation was 63±13 years with a male female ratio 3.2:1. Ninety-five percent cases were primary epithelial tumors and 93% cases were of urothelial origin. Low grade papillary urothelial carcinoma was the most common urothelial tumor (40.5%) followed by high grade papillary urothelial carcinoma (34.5%). Some rare types like primary adenocarcinoma and small cell carcinoma were also seen in this study (1.2% each). Muscle invasion was significantly higher in high grade (66%) as compared to low grade papillary urothelial carcinoma (3%). Muscle tissue was absent in 8 (9.5%) cases.Conclusion: There is relationship of histologic grade with aggressiveness of tumor. Most of the high grade tumors are muscle invasive at presentation. Submission of muscle tissue is important for optimal patient management.Asian Journal of Medical Sciences Vol.9(6) 2018 45-50

scholarly journals Profiles of histopathological lesions of urinary bladder: A five years study

2016 ◽  
Vol 6 (12) ◽  
pp. 1001-1004
Author(s):  
EP Shrestha ◽  
K Karmacharya
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Lamina Propria ◽  
Bladder Neoplasms ◽  
Low Grade ◽  
High Grade ◽  
Army Hospital ◽  
Neoplastic Lesions ◽  
Muscle Invasion

Background: Neoplastic and non-neoplastic urinary bladder lesions are the main reasons for morbidity and mortality throughout the world. Amongst these, urothelial carcinoma is a common primary tumor of urinary bladder (90%). The objective of this study is to determine the profile of various urothelial lesions received in Army Hospital within 5 years of period.Materials and methods: Five years retrospective study of cystoscopic biopsies and radical cystectomy specimens were carried out in Department of Pathology, Army hospital.Results: Out of 53 cystoscopic biopsies and radical cystectomy specimens, 42 were neoplastic and 11 were non neoplastic lesions. Thirty six urothelial carcinomas were observed out of which 20 were high grade urothelial carcinoma and 16 were low grade. Out of 20 high grade urothelial carcinoma, 17 had muscle invasion and 3 had invasion upto lamina propria. Of 16 low grade urothelial carcinoma, 12 were noninvasive, 2 had invasion upto lamina propria and 2 had muscle invasion. Papilloma was the commonest benign lesions found (7.1%) followed by papillary urothelial neoplasms of low malignant potential (PUNLMP) (2.4%) and hemangioma (2.4%).Conclusion: This article have highlighted upon the importance of histopathological study in evaluating urinary bladder lesions. Also, it has helped in determining that neoplastic lesions were more common than non-neoplastic lesions as seen in our study. A great majority of neoplastic lesions were of urothelial origin. Cystoscopic studies and biopsies help in early detection of bladder neoplasms and they form the mainstay of the diagnosis and follow up.

scholarly journals Spectrum of histomorphological diagnosis in cystoscopic bladder biopsies

2017 ◽  
Vol 7 (1) ◽  
pp. 1062-1065
Author(s):  
R Thapa ◽  
M Lakhey ◽  
AD Bhatta
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Clinical Symptoms ◽  
Transitional Cell ◽  
Research Centre ◽  
Low Grade ◽  
Bladder Tumors ◽  
Primary Tumors ◽  
Neoplastic Lesions ◽  
Papillary Urothelial Carcinoma

Background:  Urinary bladder lesions are the main source of significant clinical symptoms which are more disabling than lethal. Bladder tumors constitute one of the most common urological pathology. Urothelial carcinoma accounts for 90% of all primary tumors of the bladder. This study aimed to determine the frequency of different types of lesions of the urinary bladder and to determine the grade and stage of urothelial tumors.Materials and Methods: This is a 2 years cross sectional study of cystoscopic biopsies carried out in the Department of Pathology, Medicare National Hospital and Research Centre, Kathmandu, Nepal.Results:  Out of 87 cases, 58 (66.67%) cases were neoplastic lesions and 29(33.33%) cases were non- neoplastic lesions. Majority of neoplastic lesions 96.55% were urothelial (transitional cell) tumors comprising predominantly of low grade papillary urothelial carcinoma 50.91%. Muscle invasion was seen only in high grade papillary urothelial carcinomas.Conclusion: Among bladder tumors low grade papillary urothelial carcinoma is the most common. 

Utility of GATA-3 and Cytokeratin 5/6 Immunostains in Separating Condyloma Acuminatum Arising in the Urinary Tract From Non-Invasive Papillary Urothelial Carcinoma

2021 ◽  
pp. 106689692110522
Author(s):  
Diego Montoya-Cerrillo ◽  
Laurence M. Briski ◽  
Merce Jorda ◽  
Oleksandr N. Kryvenko
Keyword(s):  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Condylomata Acuminata ◽  
Condyloma Acuminatum ◽  
Low Risk ◽  
Low Grade ◽  
High Grade ◽  
Non Invasive ◽  
Urothelial Carcinomas ◽  
Papillary Urothelial Carcinoma

Background Condyloma acuminatum is a squamous epithelial lesion which uncommonly involves the urinary tract. In this location, non-invasive papillary urothelial carcinoma constitutes one of the main differential diagnoses with significant prognostic and therapeutic implications. To date, no ancillary immunohistochemical stain has been described to differentiate these two entities. We assess the utility of cytokeratin 5/6 (CK5/6) and GATA-3 immunohistochemistry in distinguishing condyloma acuminatum from non-invasive papillary urothelial carcinoma. Design We reviewed 9 condylomata acuminata involving the urinary tract, 12 low-grade and 8 high-grade non-invasive papillary urothelial carcinomas. CK5/6 immunostaining was performed in all cases. GATA-3 immunostaining and low-risk human papilloma virus (HPV) chromogenic in situ hybridization was performed in all condyloma cases and 2 urothelial carcinomas with squamous differentiation. Results 8/9 condylomata acuminata were positive for low-risk HPV. All condylomata acuminata exhibited strong full-thickness cytoplasmic staining for CK5/6. In 10 of 12 low-grade non-invasive papillary urothelial carcinomas, CK5/6 expression was continuous and limited to the basal cell layer, while it was patchy and limited to the basal cell layer in all 8 high-grade non-invasive papillary urothelial carcinomas. Two low-grade non-invasive papillary urothelial carcinomas showed focal full-thickness CK5/6 expression in the areas of squamous differentiation. These 2 cases were negative for low-risk HPV. GATA-3 immunostaining was positive in all condylomata acuminata. Conclusions CK5/6 immunostaining is a useful and simple tool that can help separate low-grade and high-grade non-invasive papillary urothelial carcinomas from condyloma acuminatum involving the urothelium-lined organs. GATA-3 has no discriminatory role between condyloma acuminatum and papillary urothelial carcinomas.

Comparison between 1973 and 2004/2016 WHO grading systems in patients with Ta urothelial carcinoma of urinary bladder

2021 ◽  
pp. jclinpath-2021-207400
Author(s):  
Claudia Collà Ruvolo ◽  
Christoph Würnschimmel ◽  
Mike Wenzel ◽  
Luigi Nocera ◽  
Gianluigi Califano ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Cox Regression ◽  
Bladder Tumour ◽  
Grading System ◽  
Low Grade ◽  
High Grade ◽  
Who Grade ◽  
Kaplan Meier ◽  
Grading Systems

AimsTo compare the 1973 WHO and the 2004/2016 WHO grading systems in patients with urothelial carcinoma of urinary bladder (UCUB), since no consensus has been made which classification should supersede the other and since both are recommended in clinical practice.MethodsNewly diagnosed patients with Ta UCUB treated with transurethral resection of bladder tumour were abstracted from the Surveillance, Epidemiology and End Results database (2010–2016). Kaplan-Meier plots and multivariable Cox regression models (CRMs) tested cancer-specific mortality (CSM), according to 1973 WHO (G1 vs G2 vs G3) and to 2004/2016 WHO (low-grade vs high-grade) grading systems.ResultsOf 35 986 patients, according to 1973 WHO grading system, 8165 (22.7%) were G1, 17 136 (47.6%) were G2 and 10 685 (29.7%) were G3. According to 2004/2016 WHO grading system, 24 961 (69.4%) were low-grade versus 11 025 (30.6%) high-grade. In multivariable CRMs, G3 (HR: 2.05, p<0.001), relative to G1, and high-grade(HR: 2.13, p<0.001), relative to low-grade, predicted higher CSM. Conversely, G2 (p=0.8) was not an independent predictor. The multivariable models without consideration of either grading system were 74% accurate in predicting 5-year CSM. After addition of 1973 WHO or 2004/2016 WHO grade, the accuracy increased to 76% and 77%, respectively.ConclusionsFrom a statistical standpoint, it appears that the 2004/2016 WHO grading system holds a small, although measurable advantage over the 1973 WHO grading system. Other considerations, such as intraobserver and interobserver variability may represent an additional matric to consider in deciding which grading system is better.

Study on Staging and Grading of Urinary Bladder Tumour with Histopathological Correlation

2014 ◽  
Vol 22 (Number 1) ◽  
pp. 3-9
Author(s):  
S Sultana ◽  
T Chowdhury ◽  
F Jahan ◽  
A.H.M. O Farooque
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Bladder Tumor ◽  
Bladder Wall ◽  
Bladder Tumour ◽  
Muscularis Propria ◽  
Low Grade ◽  
Cross Sectional ◽  
Histopathological Correlation ◽  
Papillary Urothelial Carcinoma

A cross sectional observational study was done to see the staging and grading of urinary bladder tumor along with their histopathological correlation at the Department of Pathology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The study was done during the period of July 2006 to June 2007 and total 150 cases were included those were clinically suggestive and cystoscopically or sonographically suspected cases of bladder tumor. Size of bladder, length of ureters, other organs present; tumor characteristics: size (including thickness), location extent of invasion, shape (papillary, ulcerated), multifocal lesion and appearance of non-neoplastic mucosa, thickness of bladder wall away from tumor were observed. Total 145 samples were collected by TURBT and 5 were by cystectomy. Mean age of the study patients was 58.5 years and 95.33% of them were male. Histopathologically 95.33% were papillary urothelial carcinoma, 2.66% were adenocarcinoma, 1.33% was squamous cell carcinoma and 0.66% were carcinosarcoma. Among 150 cases 72 (50.34%) bladder tumour were of high grade and 71 (49.65%) were low grade. In 7 (4.66%) cases grading were not done because they were other than papillary urothelial carcinoma. Staging were done in 93 cases and in remaining 57 cases staging was not possible due to absence of muscularis propria. 32 (21.33%) cases were stage T2, 31 (20.66%) cases T1 and 4 (2.66%) were in stage Ta. Overall findings of the cross sectional Bangladeshi population was almost similar to other developing and developed countries.

Dermatomyositis in a patient with high grade papillary urothelial carcinoma of urinary bladder

2007 ◽  
Vol 10 (2) ◽  
pp. 153-155
Author(s):  
Aman SHARMA ◽  
Susheel KUMAR ◽  
Ajay WANCHU ◽  
A. K. MANDAL ◽  
Surjit SINGH ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
High Grade ◽  
Papillary Urothelial Carcinoma

scholarly journals Interobserver reproducibility of The Paris System for Reporting Urinary Cytology

CytoJournal ◽  
2017 ◽  
Vol 14 ◽  
pp. 17 ◽  
Author(s):  
Theresa Long ◽  
Lester J. Layfield ◽  
Magda Esebua ◽  
Shellaine R. Frazier ◽  
D. Tamar Giorgadze ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Urinary Cytology ◽  
Low Grade ◽  
High Grade ◽  
Urothelial Cells ◽  
Urothelial Carcinomas ◽  
Absolute Agreement ◽  
Potential Impact ◽  
Urine Specimens

Background: The Paris System for Reporting Urinary Cytology represents a significant improvement in classification of urinary specimens. The system acknowledges the difficulty in cytologically diagnosing low-grade urothelial carcinomas and has developed categories to deal with this issue. The system uses six categories: unsatisfactory, negative for high-grade urothelial carcinoma (NHGUC), atypical urothelial cells, suspicious for high-grade urothelial carcinoma, high-grade urothelial carcinoma, other malignancies and a seventh subcategory (low-grade urothelial neoplasm). Methods: Three hundred and fifty-seven urine specimens were independently reviewed by four cytopathologists unaware of the previous diagnoses. Each cytopathologist rendered a diagnosis according to the Paris System categories. Agreement was assessed using absolute agreement and weighted chance-corrected agreement (kappa). Disagreements were classified as low impact and high impact based on the potential impact of a misclassification on clinical management. Results: The average absolute agreement was 65% with an average expected agreement of 44%. The average chance-corrected agreement (kappa) was 0.32. Nine hundred and ninety-nine of 1902 comparisons between rater pairs were in agreement, but 12% of comparisons differed by two or more categories for the category NHGUC. Approximately 15% of the disagreements were classified as high clinical impact. Conclusions: Our findings indicated that the scheme recommended by the Paris System shows adequate precision for the category NHGUC, but the other categories demonstrated unacceptable interobserver variability. This low level of diagnostic precision may negatively impact the applicability of the Paris System for widespread clinical application.

scholarly journals Urothelial Tumors of the Urinary Bladder in Young Patients: A Clinicopathologic Study of 59 Cases

2013 ◽  
Vol 137 (10) ◽  
pp. 1337-1341 ◽  
Author(s):  
Melissa L. Stanton ◽  
Li Xiao ◽  
Bogdan A. Czerniak ◽  
Charles C. Guo
Keyword(s):  
Urinary Bladder ◽  
Clinical Outcomes ◽  
Young Patients ◽  
Muscularis Propria ◽  
Low Grade ◽  
High Grade ◽  
Urothelial Carcinomas ◽  
Pathologic Features ◽  
Urothelial Tumors

Context.—Urothelial tumors are rare in young patients. Because of their rarity, the natural history of the disease in young patients remains poorly understood. Objective.—To understand the pathologic and clinical features of urothelial tumors of the urinary bladder in young patients. Design.—We identified 59 young patients with urothelial tumors of the urinary bladder treated at our institution and analyzed the tumors' pathologic features and the patients' clinical outcomes. Results.—All patients were 30 years or younger, with a mean age of 23.5 years (range, 4–30). Thirty-eight patients (64%) were male, and 21 (36%) were female. Most tumors were noninvasive, papillary urothelial tumors (49 of 59; 83%), including papillary urothelial neoplasms of low malignant potential (7 of 49; 14%), low-grade papillary urothelial carcinomas (38 of 49; 78%), and high-grade papillary urothelial carcinomas (4 of 49; 8%). Only a few (n = 10) of the urothelial tumors were invasive, invading the lamina propria (n = 5; 50%), muscularis propria (n = 4; 40%), or perivesical soft tissue (n = 1; 10%). Clinical follow-up information was available for 41 patients (69%), with a mean follow-up time of 77 months. Of 31 patients with noninvasive papillary urothelial tumors, only 1 patient (3%) later developed an invasive urothelial carcinoma and died of the disease, and 30 of these patients (97%) were alive at the end of follow-up, although 10 (32%) had local tumor recurrences. In the 10 patients with invasive urothelial carcinomas, 3 patients (30%) died of the disease and 5 others (50%) were alive with metastases (the other 2 [20%] were alive with no recurrence). Conclusion.—Urothelial tumors in young patients are mostly noninvasive, papillary carcinomas and have an excellent prognosis; however, a small subset of patients may present with high-grade invasive urothelial carcinomas that result in poor clinical outcomes.

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