Handling and Pathology Reporting of Specimens with Carcinoma of the Urinary Bladder, Ureter, and Renal Pelvis (original) (raw)
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Urothelial neoplasms: a review of pathological reporting practices
2016
Introduction: Urothelial carcinoma has observed great strides of advances in the field of diagnostics and therapeutics. On the other hand, the last decade witnessed an upheaval in pathological grading which seems to settle down in the recent times. Aims and Objectives: Our study intends to evaluate pathology practices in reporting papillary urothelial carcinomas and highlight the features which can define prognosis and guide molecular studies. Materials and Methods: A consecutive of 32 cases of papillary urothelial carcinoma reported over duration of 2 years were collected. Histopathological slides were reviewed applying WHO/ISUP 2004 diagnostic criteria and compared with primary diagnosis. Results: High grade papillary urothelial carcinoma formed the largest group with 14 cases. Concordance between original diagnosis and review diagnosis was seen in 19 cases only. Invasion into underlying tissue was missed in 6 cases. Associated features like carcinoma in situ, lymphovascular invasion, perineural invasion and stalk invasion were missed in primary reports. Conclusion: As grade and stage dictate prognosis and management plans, it is essential to release veritable reports. The findings emphasize the need to generate a consensus report with multiple opinions.
A gamut of Histopathological Lesions of Carcinoma of Urinary Bladder-A study of 43 cases
Aims/Objective: Urinary bladder cancer is the 7 th most common cancer seen worldwide, and is considerably more common in males than females worldwide. The present study was done to determine the age, sex incidence of the tumour occurrence and to study histopathological features of urinary bladder carcinoma with clinical background and to analyse the data descriptively. Materials and Methods: This prospective study was done with the biopsy and resected specimen of the urinary bladder carcinoma during a period of two years (October 2012-June 2014) from Yenepoya Medical College hospital, Mangalore. The specimens were received in 10% formalin and subjected to macroscopic description and appropriate relevant clinical details were noted. Standard tissue sections were given. Microscopic features were studied with H&E stained tissue sections using the parameters described in the proforma. Results: The present study was done on 43 cases of urinary bladder carcinomas. Cases occurred in age range of 42-91 years, peak incidence was seen in 6th decade of life, with a male to female ration of 3.1:1.No case was seen below 40 years of age. Haematuria was the most common presenting symptom, while lateral wall of urinary bladder was the commonest site of urinary bladder carcinoma with 58% of cases. Transitional cell carcinomas were the most common histological type found. 23 cases of non-invasive papillary urothelial carcinomas and 20 cases of invasive urothelial carcinomas were seen. Among non-invasive papillary urothelial carcinoma 15 cases were of low grade non-invasive carcinoma and 8 cases were of high grade non-invasive carcinoma. Conclusion: Urinary bladder carcinoma patients present in advanced stages with an overall poor survival. Incidence and prognosis can be improved by reduction of risk factors and early detection. Few of the most promising patient approaches for improving patient prognosis focus on techniques that allow early diagnosis in their early stages.
A histological analysis of urinary bladder specimens with elaboration of various neoplastic lesions
IP innovative publication pvt. ltd, 2019
Introduction: Lesions of urinary bladder constitute an important source of clinical signs and symptoms. Both neoplastic and non-neoplastic lesions do occur commonly, however the former being the most common type. Majority of urinary tract tumors are epithelial in origin, among which 90% of them are urothelial in origin. Objective: To evaluate the histopathological spectrum of urinary bladder lesions with emphasis on the neoplastic lesions with reference to 2016 WHO classification of tumors of urinary system. Materials and Methods: This was a prospective study and includes all the urinary bladder specimens received. They were examined grossly and processed completely as per the standard procedure. Multiple sections of 3-5microns were taken and stained with H&E, followed by light microscopic examination to study various non-neoplastic and neoplastic lesions. Results: Total 65 cases were studied, 30 were cystoscopic biopsies and 35 were TURBT specimens. There were 40 males and 25 females constituting up to 61.54 % and 38.46 % respectively. Chronic non-specific cystitis was the common non-neoplastic lesion. Among neoplastic lesion, Invasive urothelial carcinoma was the predominant lesion constituting 22 cases (62.86%). These neoplastic lesions were more common among males (74.28%) with M:F ratio of 2.8:1. Conclusion: Urinary bladder lesions are most frequently encountered by surgical pathologists and are heterogenous. Both benign and malignant lesions are well documented but latter being more common. Many of these are more common in elderly people with male predilection and are often associated with smoking. Identifying the extent of invasion by microscopic examination constitutes an important aspect in urothelial carcinomas.
Histopathological Evaluation of Patients with Bladder Urothelial Carcinoma Diagnosed in Our Clinic
Istanbul Medical Journal, 2017
In our study, the age and gender of patients and the stage and grade of conventional bladder urothelial carcinoma (UC) and bladder UC variants were investigated. Methods: Patients with UC diagnosed in our pathology clinic between 2010 and 2015 were identified using an electronic database. They were reexamined according to the World Health Organization 2004 (WHO) classification system, and the grade and stage of UC and concomitant UC variants were documented for each patient. In addition to these data, the age and gender of each patient were obtained from the electronic database. Results: Between 2010 and 2015, 1355 biopsies from 1081 different patients were present with the diagnosis of UC. Totally, 676 patients with recurrence were excluded. Finally, 679 patients were included. When all patients were screened in terms of newly identified variants in the WHO 2004 classification system, 153 patients (22.6%) had UC variants, forming at least 10% of the biopsy specimen. We identified 15 UC variants: squamous differentiation, glandular differentiation, and small cell, micropapillary, sarcomatoid, lymphoepithelioma-like, nested, large nested, large cell neuroendocrine, plasmacytoid, pleomorphic, trophoblastic, rhabdoid, chordoid, and undifferentiated carcinomas. Conclusion: Our study is the largest case series on UC in Turkey. Due to the large number of patients, we believe that the results reflect the present status of the frequency and stage of UC variants and the gender and age of patients at diagnosis.
Utility of Urine Cytology in Urinary Tract Neoplasm with Histopathological Correlation
https://ijshr.com/IJSHR\_Vol.4\_Issue.3\_July2019/IJSHR\_Abstract.0031.html, 2019
Background: Urinary bladder tumor is the sixth most common tumor diagnosed worldwide. Urine cytology is an important screening tool of patients for urothelial carcinoma (UC) and follow-up of patients with treated disease. The aim of this study to determine the sensitivity of urine cytology in detection of urinary tract neoplasms with its clinical and histopathological correlation. Material & Methods: A five years prospective study includes 73 cases of urine cytology from January 2014 to December 2018 at a tertiary care hospital in the Department of Pathology. Urine cytology slides were reviewed and were correlated with histopathological diagnosis. Results: Out of 73 cases, histopathological follow up received only in 43 cases. Out of that, 33 were male and 10 were female. Male to female ratio is 3.3:1. Maximum age incidence was found 5th-6th decade. Hematuria was most common and presenting complaint found in 90% of cases. Urothelial carcinoma was most common neoplasm comprising for 87.5% of bladder tumors, Squamous cell carcinoma comprising 7.5%. The overall urine cytology sensitivity combining with the positive and suspicious result was 77.5%. Conclusion: Urine cytology, despite its variable sensitivity remains a useful tool in evaluating suspected urothelial malignancies. Positive urine cytology requires confirmation with cystoscopy and biopsy before instituting any form of definitive therapy and a negative cytology does not always exclude malignant disease. Keywords: Urothelial carcinoma, Urine cytology.
Journal of Clinical & Experimental Pathology, 2017
Objective: The purpose of the current study is to perform a standardized comparison of original and internal repeat pathology reviews of identical bladder specimens to identify discrepancies and characterize the impact of repeat review on treatment decisions as well as identify patients most likely to benefit from this practice. Materials/Methods: Ninety-one patients with an outside diagnosis of urothelial cancer of the bladder were referred to our institution for repeat review of 91 bladder resection specimens and biopsies. A discrepancy in either the presence or absence of muscularis propria and presence of invasive disease in the muscularis propria was deemed a "treatment-altering" characteristic, while presence of carcinoma in situ, lymphovascular invasion, or micropapillary features was deemed a "clinically-significant" characteristic. Results: After repeat review at our institution, 29.7% (27) specimens had treatment altering discrepancies, and 61.5% (56) specimens had at least one clinically-significant discrepancy. Conclusion: Repeat review of referred bladder specimens frequently impacts treatment decisions in patients with urothelial carcinoma.
Profiles of histopathological lesions of urinary bladder: A five years study
Journal of Pathology of Nepal, 2016
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.
Histopathological Gamut of Urinary Bladder Tumors: An Institutional Study
Introduction: The present study was taken up to assess the incidence of different histological variants of bladder tumors, site, age and sex distribution, presenting symptoms and a brief comparison was done about the histopathological features of the tumors occurring in young and old individuals. Material and methods: The present study is a retrospective two year descriptive study conducted in the Department of Pathology, tertiary care hospital in Guntur. The biological materials included in the study were Trans-urethral resection of bladder tumor (TURBT) specimens, complete and partial cystectomies. The formalin fixed specimens were routinely processed and haematoxylin and eosin stained slides were retrieved from the departmental archives and reviewed. Results: The most common location for bladder tumors in the present study was lateral wall constituting 40.9% of the cases followed by posterior wall (20.4%), trigone (13.6%), neck (11.3%), anterior wall (9.1%) and ureteric orifice (4.5%). Conclusion: To conclude, urothelial carcinomas are rare and prognostically better in the age group below 40 years, as most present with non invasive low grade papillary urothelial carcinomas.