Urinary bladder: Difference between revisions

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==Bladder cancer==
==Bladder cancer==
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>
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>
If cancer is detected during microscopy:
*Determine the histopathological '''type''' of cancer
*Perform '''grading''' and '''staging'''


===Urothelial carcinoma===
===Urothelial carcinoma===
Line 44: Line 48:
===Non-urothelial cancers===
===Non-urothelial cancers===
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/>
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/>
===Staging===
In the TNM staging system (AJCC 8th Edn. 2017) for bladder cancer:<ref>{{cite web |title=EAU Guidelines - STAGING AND CLASSIFICATION SYSTEMS |url=https://uroweb.org/guideline/non-muscle-invasive-bladder-cancer/#4 |website=Uroweb}}</ref><ref>{{cite journal | vauthors = Magers MJ, Lopez-Beltran A, Montironi R, Williamson SR, Kaimakliotis HZ, Cheng L | title = Staging of bladder cancer | journal = Histopathology | volume = 74 | issue = 1 | pages = 112–134 | date = January 2019 | pmid = 30565300 | doi = 10.1111/his.13734 | doi-access = free }}</ref>
'''T (Primary tumor)'''
* '''TX''' Primary tumor cannot be assessed
* '''T0''' No evidence of primary tumor
*'''Ta''' Non-invasive papillary carcinoma
* '''Tis''' Carcinoma in situ ('flat tumor')
* '''T1''' Tumur invades subepithelial connective tissue
* '''T2a''' Tumour invades superficial muscle (inner half of the detrusor muscle)<ref name=CancerNet>{{cite web|url=https://www.cancer.net/cancer-types/bladder-cancer/stages-and-grades|title=Bladder Cancer: Stages and Grades|website=[[Cancer.net]]}} Approved by the Cancer.Net Editorial Board 05/2019</ref>
* '''T2b''' Tumour invades deep muscle (outer half of the detrusor muscle)<ref name=CancerNet/>
* '''T3''' Tumor invades perivesical tissue:
** '''T3a''' Microscopically
** '''T3b''' Macroscopically (extravesical mass)
* '''T4a''' Tumor invades prostate, uterus or vagina
* '''T4b''' Tumor invades pelvic wall or abdominal wall
'''N (Lymph nodes)'''
* '''NX''' Regional lymph nodes cannot be assessed
* '''N0''' No regional lymph node metastasis
* '''N1''' Metastasis in a single lymph node in true pelvis (hypogastric, obturator, external iliac, or presacral nodes)
* '''N2''' Metastasis in multiple lymph nodes in true pelvis (hypogastric, obturator, external iliac, or presacral nodes)
* '''N3''' Metastasis in common iliac lymph nodes
'''M (Distant metastasis)'''
Can be performed if tissues have been submitted from distant sites.
* '''MX''' Distant metastasis cannot be assessed
* '''M0''' No distant metastasis
* '''M1''' Distant metastasis.
**'''M1a:''' The cancer has spread only to lymph nodes outside of the pelvis.
**'''M1b''': The cancer has spread other parts of the body.


===Microscopy report===
===Microscopy report===
*Type of cancer
*Histopathologic type of cancer
*Grade
*Grade
*Any invasion
*Stage


{{Bottom}}
{{Bottom}}

Revision as of 09:49, 29 July 2020

Author: Mikael Häggström [note 1]

Bladder cancer

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).[1]

If cancer is detected during microscopy:

  • Determine the histopathological type of cancer
  • Perform grading and staging

Urothelial carcinoma

Low grade
High grade
Variants

Non-urothelial cancers

The other 5% of urinary bladder cancer types are squamous cell carcinomas, adenocarcinomas, sarcomas, small cell carcinomas, and secondary deposits from cancers elsewhere in the body.[1]

Staging

In the TNM staging system (AJCC 8th Edn. 2017) for bladder cancer:[2][3]

T (Primary tumor)

  • TX Primary tumor cannot be assessed
  • T0 No evidence of primary tumor
  • Ta Non-invasive papillary carcinoma
  • Tis Carcinoma in situ ('flat tumor')
  • T1 Tumur invades subepithelial connective tissue
  • T2a Tumour invades superficial muscle (inner half of the detrusor muscle)[4]
  • T2b Tumour invades deep muscle (outer half of the detrusor muscle)[4]
  • T3 Tumor invades perivesical tissue:
    • T3a Microscopically
    • T3b Macroscopically (extravesical mass)
  • T4a Tumor invades prostate, uterus or vagina
  • T4b Tumor invades pelvic wall or abdominal wall

N (Lymph nodes)

  • NX Regional lymph nodes cannot be assessed
  • N0 No regional lymph node metastasis
  • N1 Metastasis in a single lymph node in true pelvis (hypogastric, obturator, external iliac, or presacral nodes)
  • N2 Metastasis in multiple lymph nodes in true pelvis (hypogastric, obturator, external iliac, or presacral nodes)
  • N3 Metastasis in common iliac lymph nodes

M (Distant metastasis) Can be performed if tissues have been submitted from distant sites.

  • MX Distant metastasis cannot be assessed
  • M0 No distant metastasis
  • M1 Distant metastasis.
    • M1a: The cancer has spread only to lymph nodes outside of the pelvis.
    • M1b: The cancer has spread other parts of the body.

Microscopy report

  • Histopathologic type of cancer
  • Grade
  • Stage

Notes

  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. ↑ 1.0 1.1 . Types of Bladder Cancer: TCC & Other Variants. CTCA.
  2. ↑ . EAU Guidelines - STAGING AND CLASSIFICATION SYSTEMS. Uroweb.
  3. ↑ "Staging of bladder cancer ". Histopathology 74 (1): 112–134. January 2019. doi:10.1111/his.13734. PMID 30565300. 
  4. ↑ 4.0 4.1 . Bladder Cancer: Stages and Grades. Cancer.net. Approved by the Cancer.Net Editorial Board 05/2019

Image sources


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