Difference between revisions of "Urinary bladder"

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==Bladder cancer==
 
==Bladder cancer==
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The main condition of interest in urinary bladder cytologies and biopsies is bladder cancer. 95% of bladder cancers are transitional cell carcinoma (also called urothelial carcinoma).<ref name=CancerCenter>{{Cite web|url=https://www.cancercenter.com/bladder-cancer/types/|title=Types of Bladder Cancer: TCC & Other Variants|website=CTCA|access-date=2018-08-10}}</ref>
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The main condition of interest in urinary bladder cytologies and biopsies is bladder cancer.
  
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===Urothelial carcinoma===
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===Gross reporting of transurethral resections===
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;Low grade
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*Generally submit '''all''' material.<ref group=notes>It may be sufficient to submit representative sections that include the muscular layer, if grossly identified. Yet, many departments require submission of the entire specimen regardless, so if unsure, that is the safe choice.</ref>
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<gallery mode=packed heights=200>
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*Submit in tea bags or equivalent.<ref>Tissue from transurethral resections are generally very brittle and may escape the openings of a conventional cassette.</ref>
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File:Papillary urothelial carcinoma (low-grade), very high mag.jpg|'''Low grade''': Urothelium is thickened but only slightly atypical and has maintained polarity.
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File:Papillary urothelial carcinoma (low-grade), high mag.1.jpg|Intermediate magnification.
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Example report:
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File:Papillary urothelial carcinoma (low-grade), low mag.jpg|Low magnification
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{|class=wikitable
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File:Papillary urothelial carcinoma (low-grade), high mag.3.jpg|'''Low grade'''
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| Container A. Labeled "bladder tumor". The specimen is received in formalin and consists of multiple fragments of tan-gray, friable soft tissue measuring about __ x __ x __ cm in aggregate. The specimen is entirely submitted for microscopic examination in __ cassettes.
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File:Papillary urothelial carcinoma (low-grade) - inverted variant, very high mag.jpg|'''Low grade'''
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|}
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File:Papillary urothelial carcinoma (low-grade) - inverted variant, intermed. mag.jpg|Low-magnification of the same case, showing inverted growth.
 
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</gallery>
 
  
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;High grade
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===Microscopy===
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<gallery mode=packed heights=200>
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Mainly look for '''[[urothelial carcinoma]]''' (also called transitional cell carcinoma), which constitutes 95% of bladder cancers.<ref name=CancerCenter>{{Cite web|url=https://www.cancercenter.com/bladder-cancer/types/|title=Types of Bladder Cancer: TCC & Other Variants|website=CTCA|access-date=2018-08-10}}</ref>
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File:Papillary urothelial carcinoma (high-grade), very high mag.jpg|'''High grade''': Loss of polarity and severe abnormal cytology.
 
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File:Papillary urothelial carcinoma (high-grade), intermed. mag.1.jpg|Low-magnification of same case, showing papillary architecture.
 
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File:Urothelial carcinoma with marked pleomorphism, very high mag.2.jpg|With giant, bizarre, anaplastic cells
 
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File:Papillary urothelial carcinoma with early invasion, high mag.jpg|High grade, with early '''invasion''', showing single cells and irregularly shaped nests of tumor cells infiltrating the underlying stroma.
 
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</gallery>
 
  
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;Variants
 
 
<gallery mode=packed heights=200>
 
<gallery mode=packed heights=200>
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File:Micropapillary urothelial carcinoma, very high mag.jpg|'''Micropapillary''': Micropapillary clusters of tumor cells within lacunae
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File:Papillary urothelial carcinoma (low-grade), very high mag.jpg|'''Low grade [[urothelial carcinoma]]''': Urothelium is thickened but only slightly atypical and has maintained polarity.
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File:Papillary urothelial carcinoma with cribriform morphology, very high mag.jpg|'''Cribriform''', high magnification
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File:Papillary urothelial carcinoma (high-grade), very high mag.jpg|'''High grade [[urothelial carcinoma]]''': Loss of polarity and severe abnormal cytology.
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File:Papillary urothelial carcinoma with cribriform morphology, low mag.jpg|'''Cribriform''', low magnification
 
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File:Urothelial carcinoma with glandular differentiation, high mag.jpg|Another case of '''glandular differentiation''', showing luminal spaces with proteinaceous secretions
 
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File:Papillary urothelial carcinoma with glandular differentiation, high mag.jpg|Another case of '''glandular differentiation'''
 
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File:Urothelial carcinoma with glandular differentiation, very high mag.1.jpg|Another case of '''glandular differentiation'''
 
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File:Plasmacytoid urothelial carcinoma, very high mag.1.jpg|'''Plasmacytoid''': Monotonous discohesive cells with eosinophilic cytoplasm and eccentric nuclei.
 
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File:Urothelial carcinoma - stage pT1, high mag.jpg|With ''' inflammatory stromal reaction'''
 
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File:Urothelial carcinoma with squamous differentiation, very high mag.jpg|With '''squamous''' differentiation
 
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File:Urothelial carcinoma with villoglandular differentiation, high mag.jpg|'''Villoglandular''': glandular differentiation and villous architecture
 
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File:Urothelial carcinoma with villoglandular differentiation, intermed. mag.2.jpg|Another '''villoglandular''' case. Typical papillary urothelial carcinoma is seen on the left
 
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File:Urothelial carcinoma with micropapillary features, high mag.jpg|With prominent '''retraction artifacts'''
 
 
</gallery>
 
</gallery>
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===Non-urothelial cancers===
 
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The other 5% of urinary bladder cancer types are [[squamous cell carcinoma]]s, [[adenocarcinoma]]s, [[sarcoma]]s, [[small cell carcinoma]]s, and secondary deposits from cancers elsewhere in the body.<ref name=CancerCenter/>
 
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===Microscopy report===
 
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*Type of cancer
 
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*Grade
 
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*Any invasion
 
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{{Bottom}}
 
{{Bottom}}

Revision as of 13:24, 7 November 2020

Author: Mikael Häggström [note 1]

Bladder cancer

The main condition of interest in urinary bladder cytologies and biopsies is bladder cancer.

Gross reporting of transurethral resections

  • Generally submit all material.[notes 1]
  • Submit in tea bags or equivalent.[1]

Example report:

Container A. Labeled "bladder tumor". The specimen is received in formalin and consists of multiple fragments of tan-gray, friable soft tissue measuring about __ x __ x __ cm in aggregate. The specimen is entirely submitted for microscopic examination in __ cassettes.

Microscopy

Mainly look for urothelial carcinoma (also called transitional cell carcinoma), which constitutes 95% of bladder cancers.[2]

Notes

  1. ↑ It may be sufficient to submit representative sections that include the muscular layer, if grossly identified. Yet, many departments require submission of the entire specimen regardless, so if unsure, that is the safe choice.
  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. ↑ Tissue from transurethral resections are generally very brittle and may escape the openings of a conventional cassette.
  2. ↑ . Types of Bladder Cancer: TCC & Other Variants. CTCA.

Image sources


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