48,466
edits
Difference between revisions of "High-grade papillary urothelial carcinoma"
Jump to navigation
Jump to search
High-grade papillary urothelial carcinoma (view source)
Revision as of 01:43, 22 February 2017
, 01:43, 22 February 2017no edit summary
| (14 intermediate revisions by the same user not shown) | |||
| Line 5: | Line 5: | ||
| Caption = High-grade papillary urothelial carcinoma. [[H&E stain]]. | | Caption = High-grade papillary urothelial carcinoma. [[H&E stain]]. | ||
| Micro = papillae with "architectural complexity" (fused papillae, branching of papillae), +/-nuclear pleomorphism, nuclear enlargement - often 4-5x the size of stromal lymphocytes, mitoses (common), +/-invasion into the lamina propria (common) | | Micro = papillae with "architectural complexity" (fused papillae, branching of papillae), +/-nuclear pleomorphism, nuclear enlargement - often 4-5x the size of stromal lymphocytes, mitoses (common), +/-invasion into the lamina propria (common) | ||
| Subtypes = | | Subtypes = subtype of [[urothelial carcinoma]] | ||
| LMDDx = [[low-grade papillary urothelial carcinoma]], [[urothelial carcinoma in situ]], [[squamous cell carcinoma]] | | LMDDx = [[low-grade papillary urothelial carcinoma]], [[urothelial carcinoma in situ]], [[squamous cell carcinoma]] | ||
| Stains = | | Stains = | ||
| IHC = Ki-67 high (>35% of cells) | | IHC = Ki-67 high (>35% of cells), PAX8 -ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
| Line 57: | Line 57: | ||
DDx: | DDx: | ||
*[[Low grade papillary urothelial carcinoma]]. | *[[Low grade papillary urothelial carcinoma]]. | ||
**Stanford criteria has a 5% rule -- if the high-grade component is <5% it is low-grade.<ref>URL: [http://surgpathcriteria.stanford.edu/bladder/tcc-papillary-transitional-urothelial-carcinoma/ http://surgpathcriteria.stanford.edu/bladder/tcc-papillary-transitional-urothelial-carcinoma/]. Accessed on: 27 January 2014.</ref> | |||
***There is some evidence to suggest low-grade with <5% high-grade behaves similar to low-grade.<ref name=pmid26520419>{{Cite journal | last1 = Reis | first1 = LO. | last2 = Taheri | first2 = D. | last3 = Chaux | first3 = A. | last4 = Guner | first4 = G. | last5 = Mendoza Rodriguez | first5 = MA. | last6 = Bivalacqua | first6 = TJ. | last7 = Schoenberg | first7 = MP. | last8 = Epstein | first8 = JI. | last9 = Netto | first9 = GJ. | title = Significance of a minor high-grade component in a low-grade noninvasive papillary urothelial carcinoma of bladder. | journal = Hum Pathol | volume = 47 | issue = 1 | pages = 20-5 | month = Jan | year = 2016 | doi = 10.1016/j.humpath.2015.09.007 | PMID = 26520419 }}></ref> | |||
*[[Prostate carcinoma]] with pseudopapillae<ref name=pmid24503758>{{cite journal |author=Gordetsky J, Epstein JI |title=Pseudopapillary features in prostatic adenocarcinoma mimicking urothelial carcinoma: a diagnostic pitfall |journal=Am. J. Surg. Pathol. |volume=38 |issue=7 |pages=941–5 |year=2014 |month=July |pmid=24503758 |doi=10.1097/PAS.0000000000000178 |url=}}</ref> - see ''[[urothelial carcinoma-like prostatic carcinoma]]''. | |||
**Should be considered if a [[urethra]]l tumour. | |||
===Images=== | |||
<gallery> | |||
Image: High-grade papillary urothelial carcinoma -- low mag.jpg | HGPUC - low mag. | |||
Image: High-grade papillary urothelial carcinoma -- intermed mag.jpg | HGPUC - intermed. mag. | |||
Image: High-grade papillary urothelial carcinoma -- high mag.jpg | HGPUC - high mag. | |||
Image: High-grade papillary urothelial carcinoma - alt -- high mag.jpg | HGPUC - high mag. | |||
Image: High-grade papillary urothelial carcinoma - inv -- low mag.jpg | HGPUC - low mag. | |||
Image: High-grade papillary urothelial carcinoma - inv -- intermed mag.jpg | HGPUC - intermed. mag. | |||
Image: High-grade papillary urothelial carcinoma - inv -- high mag.jpg | HGPUC - high mag. | |||
</gallery> | |||
==IHC== | ==IHC== | ||
| Line 75: | Line 91: | ||
==Sign out== | ==Sign out== | ||
<pre> | |||
Urinary Bladder Tumour, Transurethral Resection: | |||
- HIGH-GRADE PAPILLARY UROTHELIAL CARCINOMA. | |||
-- NEGATIVE for lamina propria invasion. | |||
-- NEGATIVE for lymphovascular invasion. | |||
-- Please see synoptic report. | |||
- Muscularis propria present and NEGATIVE for invasion. | |||
- NEGATIVE for (flat) urothelial carcinoma in situ. | |||
</pre> | |||
====Block letters==== | |||
<pre> | <pre> | ||
URINARY BLADDER LESION ("TUMOUR"), TRANSURETHRAL RESECTION: | URINARY BLADDER LESION ("TUMOUR"), TRANSURETHRAL RESECTION: | ||
| Line 84: | Line 111: | ||
===Invasion into the lamina propria=== | ===Invasion into the lamina propria=== | ||
<pre> | |||
Urinary Bladder Tumour, Transurethral Resection: | |||
- INVASIVE HIGH-GRADE PAPILLARY UROTHELIAL CARCINOMA with lamina propria invasion. | |||
-- Muscularis propria present, NEGATIVE for muscularis propria invasion. | |||
-- NEGATIVE for lymphovascular invasion. | |||
-- Please see synoptic report. | |||
</pre> | |||
====Block letters==== | |||
<pre> | <pre> | ||
URINARY BLADDER LESION ("TUMOUR"), TRANSURETHRAL RESECTION URINARY BLADDER TUMOUR (TURBT): | URINARY BLADDER LESION ("TUMOUR"), TRANSURETHRAL RESECTION URINARY BLADDER TUMOUR (TURBT): | ||
| Line 112: | Line 148: | ||
====Micro==== | ====Micro==== | ||
The sections show urothelial mucosa with thick papillary structures. Focally, nuclei are large (~3-4x resting lymphocyte), hyperchromatic and have nucleoli. Mitotic activity is present and focally brisk (4 mitoses in 1 HPF, 1 HPF~0.2376 mm*mm). Umbrella cells are seen only focally. | |||
=====Alternate===== | |||
The sections show a small fragment of urothelial mucosa with two papillary structures, | The sections show a small fragment of urothelial mucosa with two papillary structures, | ||
enlarged nuclei (~3-4x resting lymphocyte) and moderate nuclear size variation. Mitotic activity is seen focally. Umbrella | enlarged nuclei (~3-4x resting lymphocyte) and moderate nuclear size variation. Mitotic activity is seen focally. Umbrella | ||
| Line 119: | Line 158: | ||
contains a nest with smaller cells, cystic spaces and no appreciable mitoses | contains a nest with smaller cells, cystic spaces and no appreciable mitoses | ||
(cystitis cystica). | (cystitis cystica). | ||
==See also== | ==See also== | ||
*[[Urothelium]]. | *[[Urothelium]]. | ||