Natural history of urothelial dysplasia of the bladder - PubMed (original) (raw)
Natural history of urothelial dysplasia of the bladder
L Cheng et al. Am J Surg Pathol. 1999 Apr.
Abstract
Urothelial dysplasia is the putative precursor of urothelial carcinoma in situ (CIS) and invasive urothelial carcinoma of the urinary tract. Urothelial dysplasia is frequently identified in patients with urothelial CIS and cancer. However, very little is known about the clinical presentation and natural history of urothelial dysplasia in the absence of urothelial CIS or invasive cancer. The authors studied 36 patients with isolated urothelial dysplasia at the Mayo Clinic between 1969 and 1984. None of these patients had previous or concurrent urothelial CIS or invasive cancer, and none received treatment for dysplasia. The histopathologic features of urothelial dysplasia were examined, and long-term clinical follow-up was obtained. Progression was defined as the development of urothelial CIS or carcinoma. The male-to-female ratio was 2.6:1, and the mean patient age at the time of diagnosis was 60 years (range 25-79). Urothelial dysplasia has a predilection for the posterior wall. Eleven patients had urinary irritative symptoms, 10 had hematuria, 3 had both irritative symptoms and hematuria, and 12 were found to have dysplasia incidentally. The mean follow-up was 8.2 years (range 0.1-25.5). Seven (19%) of 36 patients developed biopsy-proven progression, including 4 with CIS and 3 with invasive cancer, and 1 of them died of bladder cancer. The intervals from diagnosis to progression ranged from 6 months to 8 years (mean 2.5 years). One of the remaining 29 patients had positive cytologic results 2.5 years after the initial diagnosis of dysplasia. The authors conclude that urothelial dysplasia is a significant risk for the development of CIS and invasive urothelial carcinoma, and patients with urothelial dysplasia should be followed up closely.
Similar articles
- Flat intraepithelial lesions of the urinary bladder.
Cheng L, Cheville JC, Neumann RM, Bostwick DG. Cheng L, et al. Cancer. 2000 Feb 1;88(3):625-31. Cancer. 2000. PMID: 10649257 - Prognostic significance of atypical papillary urothelial hyperplasia.
Swierczynski SL, Epstein JI. Swierczynski SL, et al. Hum Pathol. 2002 May;33(5):512-7. doi: 10.1053/hupa.2002.124031. Hum Pathol. 2002. PMID: 12094376 - The clinical presentation and outcome of urothelial atypia on biopsy of the bladder.
Ziemba JB, Golan R, Skokan A, Patel D, Feldman MD, Bing Z, Guzzo TJ. Ziemba JB, et al. Urol Oncol. 2014 Jul;32(5):645-7. doi: 10.1016/j.urolonc.2014.01.007. Epub 2014 May 9. Urol Oncol. 2014. PMID: 24814407 - Urothelial dysplasia of the bladder: diagnostic features and clinical significance.
Lopez-Beltran A, Montironi R, Vidal A, Scarpelli M, Cheng L. Lopez-Beltran A, et al. Anal Quant Cytopathol Histpathol. 2013 Jun;35(3):121-9. Anal Quant Cytopathol Histpathol. 2013. PMID: 24344498 Review. - Dysplasia and carcinoma in situ of the urinary bladder.
Lopez-Beltran A, Marques RC, Montironi R, Reymundo C, Fonseca J, Cheng L. Lopez-Beltran A, et al. Anal Quant Cytopathol Histpathol. 2015 Feb;37(1):29-38. Anal Quant Cytopathol Histpathol. 2015. PMID: 26072632 Review.
Cited by
- Pioglitazone Induces Dysplastic Urothelial Changes in Urinary Bladder of Experimental Diabetes.
Abdel-Hamid AAM, Firgany AEL. Abdel-Hamid AAM, et al. J Microsc Ultrastruct. 2021 Aug 6;11(1):34-40. doi: 10.4103/jmau.jmau_34_21. eCollection 2023 Jan-Mar. J Microsc Ultrastruct. 2021. PMID: 37144164 Free PMC article. - Photodynamic diagnosis in upper urinary tract urothelial carcinoma: A systematic review.
Osman E, Alnaib Z, Kumar N. Osman E, et al. Arab J Urol. 2017 Mar 6;15(2):100-109. doi: 10.1016/j.aju.2017.01.003. eCollection 2017 Jun. Arab J Urol. 2017. PMID: 29071138 Free PMC article. Review. - Toxicological evaluation of subchronic use of pioglitazone in mice.
Elshama SS, El-Kenawy Ael-M, Osman HE. Elshama SS, et al. Iran J Basic Med Sci. 2016 Jul;19(7):712-9. Iran J Basic Med Sci. 2016. PMID: 27635194 Free PMC article. - Role of renal urothelium in the development and progression of kidney disease.
Carpenter AR, McHugh KM. Carpenter AR, et al. Pediatr Nephrol. 2017 Apr;32(4):557-564. doi: 10.1007/s00467-016-3385-6. Epub 2016 Apr 26. Pediatr Nephrol. 2017. PMID: 27115886 Free PMC article. Review. - Uroplakin 1b is critical in urinary tract development and urothelial differentiation and homeostasis.
Carpenter AR, Becknell MB, Ching CB, Cuaresma EJ, Chen X, Hains DS, McHugh KM. Carpenter AR, et al. Kidney Int. 2016 Mar;89(3):612-24. doi: 10.1016/j.kint.2015.11.017. Epub 2015 Dec 23. Kidney Int. 2016. PMID: 26880456 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical