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Urothelial carcinoma in situ (view source)
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'''Urothelial carcinoma in situ''', also known as '''high-grade (urothelial) dysplasia''', a non-invasive [[urothelium|urothelial]] neoplasm without papillae. | |||
It is also known as '''[[carcinoma in situ]]''', abbreviated '''CIS'''. | |||
==General== | |||
*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> | |||
==See also== | |||
*[[Urothelium]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Urothelium]] | |||