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Difference between revisions of "Urothelial carcinoma"
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→Staging
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***T1b - beyond muscularis mucosae - into submucosa. | ***T1b - beyond muscularis mucosae - into submucosa. | ||
*T2 - muscularis propria. | *T2 - muscularis propria. | ||
====Muscularis propria invasion==== | |||
The presence or absence of muscularis propria invasion is very important determination - as the clinical management changes between T1 and T2: | |||
*T1: usually conservative treatment - local excision. | |||
*T2: radical treatment - cystectomy or cystoprostatectomy. | |||
A thin layer of discontinous muscularis mucuosae is present and, especially if hypertrophic, may be confused with muscuaris propria. | |||
A comparison between muscularis propria and muscularis mucosae - adapted from Paner ''et al.'':<ref name=pmid17721199>{{Cite journal | last1 = Paner | first1 = GP. | last2 = Ro | first2 = JY. | last3 = Wojcik | first3 = EM. | last4 = Venkataraman | first4 = G. | last5 = Datta | first5 = MW. | last6 = Amin | first6 = MB. | title = Further characterization of the muscle layers and lamina propria of the urinary bladder by systematic histologic mapping: implications for pathologic staging of invasive urothelial carcinoma. | journal = Am J Surg Pathol | volume = 31 | issue = 9 | pages = 1420-9 | month = Sep | year = 2007 | doi = 10.1097/PAS.0b013e3180588283 | PMID = 17721199 }}</ref> | |||
{| class="wikitable sortable" | |||
! Feature | |||
! Muscularis mucosae | |||
! Muscularis propria | |||
|- | |||
| Outline/border | |||
| typically irregular | |||
| usually regular | |||
|- | |||
| Size of bundles ‡ | |||
| "small", may be large (hypertrophic) | |||
| usu. "large" | |||
|- | |||
| Isolated fibres | |||
| yes | |||
| no | |||
|- | |||
| Location in bladder | |||
| less common in trigone, dome very common | |||
| everywhere | |||
|- Depth † | |||
| superficial | |||
| deep | |||
|} | |||
Notes: | |||
*† The lamina propria thickness varies with location. It is thinnest in the trigone (0.5-1.6 mm) and thickest in the dome (1.0-3.1 mm). | |||
*‡ Small is defined as <4 muscle fibres; large >= 4 muscle fibres. | |||
===Subtypes of urothelial carcinoma=== | ===Subtypes of urothelial carcinoma=== | ||