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Difference between revisions of "Urothelium"
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GUP, WMSP
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m (GUP, WMSP) |
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*Invasive UCC. | *Invasive UCC. | ||
Comparison urothelial changes - flat epithelium - benign/premalignant/cancerous:<ref>GUP | Comparison urothelial changes - flat epithelium - benign/premalignant/cancerous:<ref>{{Ref GUP|155-163}}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
| ||'''Normal'''||'''Reactive atypia'''||'''Flat urothelial hyperplasia'''||'''Urothelial dysplasia'''||'''UCC in situ'''||'''Invasive UCC''' | | ||'''Normal'''||'''Reactive atypia'''||'''Flat urothelial hyperplasia'''||'''Urothelial dysplasia'''||'''UCC in situ'''||'''Invasive UCC''' | ||
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===Microscopic=== | ===Microscopic=== | ||
*Nuclear changes (key feature). | *Nuclear changes (key feature). | ||
**Enlargement of nuclei (often 4-5x the size of stromal lymphocytes) -- diagnostic.<ref>GUP | **Enlargement of nuclei (often 4-5x the size of stromal lymphocytes) -- diagnostic.<ref name=Ref_GUP161>{{Ref GUP|161}}</ref> | ||
***Normal urothelium approx. 2x the size of stromal lymphocytes. | ***Normal urothelium approx. 2x the size of stromal lymphocytes. | ||
**Nuclear pleomorphism - marked variation in size of nuclei. | **Nuclear pleomorphism - marked variation in size of nuclei. | ||
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==UCC (papillary lesions)== | ==UCC (papillary lesions)== | ||
Papillary urothelial lesions are grouped into one of five categories (listed from bad to good prognosis):<ref name= | Papillary urothelial lesions are grouped into one of five categories (listed from bad to good prognosis):<ref name=Ref_WMSP310>{{Ref WMSP|310}}</ref> | ||
*High grade papillary. | *High grade papillary. | ||
*Low grade papillary. | *Low grade papillary. | ||
| Line 139: | Line 139: | ||
===High grade papillary UCC=== | ===High grade papillary UCC=== | ||
Micro.<ref name= | Micro.<ref name=Ref_WMSP310>{{Ref WMSP|310}}</ref> | ||
*"High grade nuclear features": | *"High grade nuclear features": | ||
**Nuclear pleomorphism - often 4-5x the size of stromal lymphocytes.<ref>GUP | **Nuclear pleomorphism - often 4-5x the size of stromal lymphocytes.<ref name=Ref_GUP161>{{Ref GUP|161}}</ref> | ||
*Architectural complexity. | *Architectural complexity. | ||
**Fused papillary common. | **Fused papillary common. | ||
| Line 148: | Line 148: | ||
===Low grade papillary UCC=== | ===Low grade papillary UCC=== | ||
Micro.<ref name= | Micro.<ref name=Ref_WMSP310>{{Ref WMSP|310}}</ref> | ||
*Fused papillae. | *Fused papillae. | ||
*Papillae branch. | *Papillae branch. | ||
| Line 154: | Line 154: | ||
===PUNLUMP=== | ===PUNLUMP=== | ||
Micro.<ref name= | Micro.<ref name=Ref_WMSP310>{{Ref WMSP|310}}</ref> | ||
*Rare fused papillae. | *Rare fused papillae. | ||
*Infrequent mitoses. | *Infrequent mitoses. | ||
*Nuclei larger than papilloma - but monotonous.<ref>GUP | *Nuclei larger than papilloma - but monotonous.<ref name=Ref_GUP170>{{Ref GUP|170}}</ref> | ||
===Papilloma=== | ===Papilloma=== | ||
Micro.<ref name= | Micro.<ref name=Ref_WMSP310>{{Ref WMSP|310}}</ref> | ||
*Papillary fronds. | *Papillary fronds. | ||
*Minimal branching or fusion. | *Minimal branching or fusion. | ||
*Cytological features of normal urothelium. | *Cytological features of normal urothelium. | ||
**Normal urothelium approx. 2x the size of stromal lymphocytes.<ref>GUP | **Normal urothelium approx. 2x the size of stromal lymphocytes.<ref name=Ref_GUP161>{{Ref GUP|161}}</ref> | ||
*No mitoses. | *No mitoses. | ||
===Inverted papilloma=== | ===Inverted papilloma=== | ||
*Like papillomas... but grow downward.<ref name= | *Like papillomas... but grow downward.<ref name=Ref_WMSP310>{{Ref WMSP|310}}</ref> | ||
===Tabular comparison of papillary lesions=== | ===Tabular comparison of papillary lesions=== | ||
Urothelial cells in papillae - benign/premalignant/cancerous:<ref>GUP | Urothelial cells in papillae - benign/premalignant/cancerous:<ref>{{Ref GUP|166-175}}</ref><ref name=Ref_WMSP310>{{Ref WMSP|310}}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
| ||'''Papilloma''' ||'''PUNLMP''' ||'''low grade PUCC''' ||'''high grade PUCC''' | | ||'''Papilloma''' ||'''PUNLMP''' ||'''low grade PUCC''' ||'''high grade PUCC''' | ||