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'''Papillary urothelial neoplasm of low malignant potential''', abbreviated '''PUNLMP''', is an uncommon [[urothelium|urothelial]] lesion that is similar to [[low-grade papillary urothelial carcinoma]]. | |||
'''PUNLMP''' is pronounced ''pun-lump''. | |||
==General== | |||
*Uncommon: prevalence ~ 0-3.5%.<ref name=pmid19346063>{{cite journal |author=May M, Brookman-Amissah S, Roigas J, ''et al.'' |title=Prognostic Accuracy of Individual Uropathologists in Noninvasive Urinary Bladder Carcinoma: A Multicentre Study Comparing the 1973 and 2004 World Health Organisation Classifications |journal=Eur. Urol. |volume= 57|issue= 5|pages= 850|year=2009 |month=March |pmid=19346063 |doi=10.1016/j.eururo.2009.03.052 |url=}}</ref> | |||
*PUNLMP vs. [[low grade papillary urothelial carcinoma]] has a poor inter-rater reliability.<ref name=pmid17095142>{{cite journal |author=MacLennan GT, Kirkali Z, Cheng L |title=Histologic grading of noninvasive papillary urothelial neoplasms |journal=Eur. Urol. |volume=51 |issue=4 |pages=889–97; discussion 897–8 |year=2007 |month=April |pmid=17095142 |doi=10.1016/j.eururo.2006.10.037 |url=}}</ref> | |||
Treatment: | |||
*Excision and on-going follow-up - like non-invasive [[low grade papillary urothelial carcinoma]] (LGPUC).<ref name=pmid16697785>{{cite journal |author=Jones TD, Cheng L |title=Papillary urothelial neoplasm of low malignant potential: evolving terminology and concepts |journal=J. Urol. |volume=175 |issue=6 |pages=1995–2003 |year=2006 |month=June |pmid=16697785 |doi=10.1016/S0022-5347(06)00267-9 |url=}}</ref> | |||
**Cheng ''et al.'' have advocated abandoning the term as they are treated like [[LGPUC]]s.<ref name=pmid22542126>{{Cite journal | last1 = Cheng | first1 = L. | last2 = Maclennan | first2 = GT. | last3 = Lopez-Beltran | first3 = A. | title = Histologic grading of urothelial carcinoma: a reappraisal. | journal = Hum Pathol | volume = 43 | issue = 12 | pages = 2097-108 | month = Dec | year = 2012 | doi = 10.1016/j.humpath.2012.01.008 | PMID = 22542126 }}</ref> | |||
==Microscopic== | |||
Features:<ref name=Ref_WMSP310>{{Ref WMSP|310}}</ref> | |||
*Rare fused papillae. | |||
*Infrequent mitoses. | |||
*Nuclei larger than papilloma - but monotonous.<ref name=Ref_GUP170>{{Ref GUP|170}}</ref> | |||
DDx: | |||
*[[Low grade papillary urothelial carcinoma]]. | |||
*[[Urothelial papilloma|Papilloma]]. | |||
===Images=== | |||
<gallery> | |||
Image:Punlmp1.jpg | PUNLMP - low mag. (WC/Nephron) | |||
Image:Punlmp2.jpg | PUNLMP - high mag. (WC/Nephron) | |||
</gallery> | |||
==See also== | |||
*[[Urothelium]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Urothelium]] |
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