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Difference between revisions of "Urothelial carcinoma in situ"
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Urothelial carcinoma in situ (view source)
Revision as of 04:56, 23 November 2016
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = Urothelial carcinoma in situ -- very high mag.jpg | | Image = Urothelial carcinoma in situ -- very high mag.jpg | ||
| Width = | | Width = | ||
| Caption = Urothelial carcinoma in situ. [[H&E stain]]. | | Caption = Urothelial carcinoma in situ. [[H&E stain]]. | ||
| Line 24: | Line 24: | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = erythema or edema, may be unremarkable | ||
| Prognosis = | | Prognosis = | ||
| Other = | | Other = | ||
| ClinDDx = invasive (flat) [[urothelial carcinoma]] | | ClinDDx = invasive (flat) [[urothelial carcinoma]], inflammation (cystitis) | ||
| Tx = | | Tx = | ||
}} | }} | ||
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*Urothelial carcinoma in situ (high-grade dysplasia). | *Urothelial carcinoma in situ (high-grade dysplasia). | ||
*Invasive [[urothelial carcinoma]]. | *Invasive [[urothelial carcinoma]]. | ||
==Gross== | |||
*Flat lesion - erythema or edema, may be unremarkable.<ref name=pmid19176205>{{Cite journal | last1 = Nese | first1 = N. | last2 = Gupta | first2 = R. | last3 = Bui | first3 = MH. | last4 = Amin | first4 = MB. | title = Carcinoma in situ of the urinary bladder: review of clinicopathologic characteristics with an emphasis on aspects related to molecular diagnostic techniques and prognosis. | journal = J Natl Compr Canc Netw | volume = 7 | issue = 1 | pages = 48-57 | month = Jan | year = 2009 | doi = | PMID = 19176205 }}</ref> | |||
==Microscopic== | ==Microscopic== | ||
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===Images=== | ===Images=== | ||
<gallery> | <gallery> | ||
Image: Urothelial carcinoma in situ -- intermed mag.jpg | UCIS - intermed. mag. | Image: Urothelial carcinoma in situ -- intermed mag.jpg | UCIS - intermed. mag. (WC) | ||
Image: Urothelial carcinoma in situ -- high mag.jpg | UCIS - high mag. | Image: Urothelial carcinoma in situ -- high mag.jpg | UCIS - high mag. (WC) | ||
Image: Urothelial carcinoma in situ - alt -- high mag.jpg | UCIS - high mag. | Image: Urothelial carcinoma in situ - alt -- high mag.jpg | UCIS - high mag. (WC) | ||
Image: Urothelial carcinoma in situ -- very high mag.jpg | UCIS - very high mag. | Image: Urothelial carcinoma in situ -- very high mag.jpg | UCIS - very high mag. (WC) | ||
</gallery> | |||
<gallery> | |||
Image: Urothelial CIS -- low mag.jpg | UCIS - low mag. (WC) | |||
Image: Urothelial CIS -- intermed mag.jpg | UCIS - intermed. mag. (WC) | |||
Image: Urothelial CIS -- high mag.jpg | UCIS - high mag. (WC) | |||
Image: Urothelial CIS - CK20 -- intermed mag.jpg | UCIS - CK20 - intermed. mag. (WC) | |||
Image: Urothelial CIS - p63 -- intermed mag.jpg | UCIS - p63 - intermed. mag. (WC) | |||
Image: Urothelial CIS - Ki67 -- high mag.jpg | UCIS - Ki-67 - high mag. (WC) | |||
</gallery> | </gallery> | ||
www | ====www==== | ||
*[http://www.webpathology.com/image.asp?n=7&Case=57 Urothelial CIS (webpathology.com)]. | *[http://www.webpathology.com/image.asp?n=7&Case=57 Urothelial CIS (webpathology.com)]. | ||
*[http://www.webpathology.com/image.asp?n=10&Case=57 Urothelial CIS with shedding (webpathology.com)]. | *[http://www.webpathology.com/image.asp?n=10&Case=57 Urothelial CIS with shedding (webpathology.com)]. | ||
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==IHC== | ==IHC== | ||
[[ISUP]] consensus panel:<ref name=pmid25025364 >{{cite journal |author=Amin MB, Epstein JI, Ulbright TM, ''et al.'' |title=Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the international society of urological pathology consensus conference |journal=Am. J. Surg. Pathol. |volume=38 |issue=8 |pages=1017–22 |year=2014 |month=August |pmid=25025364 |doi=10.1097/PAS.0000000000000254 |url=}}</ref> | |||
*CK20 +ve in deep cells. | *CK20 +ve in deep cells. | ||
**Normal urothelium -- only the umbrella cells. | **Normal urothelium -- only the umbrella cells. | ||
*p53 +ve. | *p53 +ve. | ||
*CD44 -ve. | *CD44 -ve. | ||
**Positive in ''indeterminant'' and ''negative''. | |||
=== | ===Another panel=== | ||
Another panel for benign urothelium versus CIS:<ref name=pmid16932015>{{Cite journal | last1 = Yin | first1 = H. | last2 = He | first2 = Q. | last3 = Li | first3 = T. | last4 = Leong | first4 = AS. | title = Cytokeratin 20 and Ki-67 to distinguish carcinoma in situ from flat non-neoplastic urothelium. | journal = Appl Immunohistochem Mol Morphol | volume = 14 | issue = 3 | pages = 260-5 | month = Sep | year = 2006 | doi = | PMID = 16932015 }}</ref> | Another panel for benign urothelium versus CIS:<ref name=pmid16932015>{{Cite journal | last1 = Yin | first1 = H. | last2 = He | first2 = Q. | last3 = Li | first3 = T. | last4 = Leong | first4 = AS. | title = Cytokeratin 20 and Ki-67 to distinguish carcinoma in situ from flat non-neoplastic urothelium. | journal = Appl Immunohistochem Mol Morphol | volume = 14 | issue = 3 | pages = 260-5 | month = Sep | year = 2006 | doi = | PMID = 16932015 }}</ref> | ||
*[[CK20]] +ve in deep cells (23/26 cases). | *[[CK20]] +ve in deep cells (23/26 cases). | ||
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**Positive in ''indeterminant'' and ''negative''. | **Positive in ''indeterminant'' and ''negative''. | ||
====Others==== | |||
* | *AMACR +ve (80% and 50% of untreated and treated CIS respectively<ref name=pmid24225842/>). | ||
===Images=== | ===Images=== | ||