Difference between revisions of "Transurethral resection of bladder tumour grossing"

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==Introduction==
==Introduction==
TURBT specimens are common urologic pathology specimens.  
TURBT specimens are common urologic pathology specimens. TURBTs are done for [[bladder cancer]], typically [[urothelial carcinoma]]. 


==Specimen opening==
==Specimen opening==
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==Protocol==
==Protocol==
*Weight specimen.
Specimen:
*Submit in total for TUR specimens up to 10 grams.<ref name=pmid34926567>{{cite journal |authors=Mazzucchelli R, Marzioni D, Tossetta G, Pepi L, Montironi R |title=Bladder Cancer Sample Handling and Reporting: Pathologist's Point of View |journal=Front Surg |volume=8 |issue= |pages=754741 |date=2021 |pmid=34926567 |pmc=8674620 |doi=10.3389/fsurg.2021.754741 |url=}}</ref>
*Weight ___ grams.
*If tumour recognized, submit 1 block per cm of tumour.<ref name=pmid34926567/>
*Dimensions (in aggregate): ___ x ___ x ___ cm.
*Number of fragments: [1-6 / multiple (>6)].
*Appearance: [tan-gray / yellow / orange].
*Consistency: [rubbery / firm].
*Other: [none / hemorrhagic appearance / necrotic appearing].
[Submitted in total/Representative sections submitted] in block(s) ___.


Notes:
*Recommendations vary on what to do with large TUR specimens - see ''[[Transurethral_resection_of_bladder_tumour_grossing#Alternate_approaches|alternate approaches]]'' section.
† Submit 15 blocks for initial assessment - if not muscle invasive: submit more tissue.


===Protocol notes===
===Protocol notes===
*The ''European Association of Urology'' recommends submitting separately the exophytic part of the tumour and tumour base in separate containers.<ref name=pmid34926567/>
*The ''European Association of Urology'' (''EAU'') recommends submitting separately the exophytic part of the tumour and tumour base in separate containers.<ref name=pmid34926567/>
*If the specimen is submitted as per ''EAU'' recommendations, representative sampling of the exophytic part and submission of the tumour base in total may be sufficient for staging purposes.{{fact}}


====Staging====
====Staging====
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===Alternate approaches===
===Alternate approaches===
Mazzuccheli ''et al.'' suggests:<ref name=pmid34926567>{{cite journal |authors=Mazzucchelli R, Marzioni D, Tossetta G, Pepi L, Montironi R |title=Bladder Cancer Sample Handling and Reporting: Pathologist's Point of View |journal=Front Surg |volume=8 |issue= |pages=754741 |date=2021 |pmid=34926567 |pmc=8674620 |doi=10.3389/fsurg.2021.754741 |url=}}</ref>
*EIT for TUR specimens up to 10 grams.
*If tumour can be identified at gross: submit 1 block per cm of tumour + some additional tumour if >10 blocks.<ref name=pmid34926567/>
University of Chicago suggests:<ref>URL: [https://voices.uchicago.edu/grosspathology/gu-renal/bladder-turbt/ https://voices.uchicago.edu/grosspathology/gu-renal/bladder-turbt/]. Accessed on: 2024 June 10.</ref>
*Submit in total.
UCLA Health suggests:<ref>URL: [https://www.uclahealth.org/sites/default/files/documents/59/transurethral-resection-bladder-tumor-turbt-022223.pdf https://www.uclahealth.org/sites/default/files/documents/59/transurethral-resection-bladder-tumor-turbt-022223.pdf]. Accessed on: 2024 June 10.</ref>
*Submit 20 blocks.  If tissue remains consult with the pathologist.
==See also==
==See also==
*[[Urothelial carcinoma]].
*[[Urothelial carcinoma]].

Latest revision as of 12:55, 13 June 2024

This article deals with transurethral resection of bladder tumour grossing, also TURBT grossing and TUR specimens.

Introduction

TURBT specimens are common urologic pathology specimens. TURBTs are done for bladder cancer, typically urothelial carcinoma.

Specimen opening

  • Not applicable.

Protocol

Specimen:

  • Weight ___ grams.
  • Dimensions (in aggregate): ___ x ___ x ___ cm.
  • Number of fragments: [1-6 / multiple (>6)].
  • Appearance: [tan-gray / yellow / orange].
  • Consistency: [rubbery / firm].
  • Other: [none / hemorrhagic appearance / necrotic appearing].

[Submitted in total/Representative sections submitted] in block(s) ___. †

Notes:

† Submit 15 blocks for initial assessment - if not muscle invasive: submit more tissue.

Protocol notes

  • The European Association of Urology (EAU) recommends submitting separately the exophytic part of the tumour and tumour base in separate containers.[1]
  • If the specimen is submitted as per EAU recommendations, representative sampling of the exophytic part and submission of the tumour base in total may be sufficient for staging purposes.[citation needed]

Staging

  • Not done at time of gross.

Alternate approaches

Mazzuccheli et al. suggests:[1]

  • EIT for TUR specimens up to 10 grams.
  • If tumour can be identified at gross: submit 1 block per cm of tumour + some additional tumour if >10 blocks.[1]

University of Chicago suggests:[2]

  • Submit in total.

UCLA Health suggests:[3]

  • Submit 20 blocks. If tissue remains consult with the pathologist.

See also

Related protocols

References