Difference between revisions of "Urothelium"

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Urothelium (view source)

Revision as of 19:23, 5 January 2014

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→‎Urothelial carcinoma in situ: split out
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*Abbreviated ''CIS''.
*Abbreviated ''CIS''.
*[[AKA]] ''high-grade (urothelial) dysplasia''.
*[[AKA]] ''high-grade (urothelial) dysplasia''.
===General===
{{Main|Urothelial carcinoma in situ}}
*Lack papillae.
 
===Microscopic===
Features:
*Nuclear changes '''key feature'''.
**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.
**Nuclear pleomorphism - marked variation in size of nuclei.
*+/-Disordered arrangement/crowding of cells.
**In normal urothelium the cell line-up on the basement membrane.
*Umbrella cells often absent.
*+/-Mitoses present.
*+/-Enlarged nucleoli.
 
Note:
*The urothelium may be "depleted", i.e. exist only of rare large cells on the basement membrane.
**This is known as ''clinging urothelial carcinoma in situ''.<ref>{{Ref Amin|2-55}}</ref>
 
====Images====
www:
*[http://www.webpathology.com/image.asp?n=3&Case=57 Urothelial CIS (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=5&Case=57 Urothelial CIS with shedding (webpathology.com)].
*[http://www.webpathology.com/image.asp?case=57&n=1 Urothelial CIS - low mag. (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=2&Case=57 Urothelial CIS - high mag. (webpathology.com)].
 
===IHC===
Features:<ref>{{Cite journal  | last1 = Lopez-Beltran | first1 = A. | last2 = Jimenez | first2 = RE. | last3 = Montironi | first3 = R. | last4 = Patriarca | first4 = C. | last5 = Blanca | first5 = A. | last6 = Menendez | first6 = CL. | last7 = Algaba | first7 = F. | last8 = Cheng | first8 = L. | title = Flat urothelial carcinoma in situ of the bladder with glandular differentiation. | journal = Hum Pathol | volume = 42 | issue = 11 | pages = 1653-9 | month = Nov | year = 2011 | doi = 10.1016/j.humpath.2010.12.024 | PMID = 21531007 }}</ref>
*p53 +ve.
*Ki-67 high.
 
Benign urothelium vs. 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).
**Normal urothelium -- only the umbrella cells.
*Ki-67 ~50% of cells - deep and superficial.
**Normal ~10% of cells, confined to basal aspect.
 
===Sign out===
<pre>
URINARY BLADDER LESION ("TUMOUR"), TRANSURETHRAL RESECTION URINARY BLADDER TUMOUR (TURBT):
- UROTHELIAL CARCINOMA IN SITU.
- MUSCULARIS PROPRIA PRESENT.
</pre>


==Urothelial cell carcinoma==
==Urothelial cell carcinoma==
Michael
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