The main condition of interest in urinary bladder cytologies and biopsies is bladder cancer.
Gross reporting of transurethral resections
|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.|
If cancer is detected during microscopy:
- Determine the histopathological type of cancer. 95% of bladder cancers are transitional cell carcinoma (also called urothelial carcinoma).
- Perform grading and staging
- Low grade
- High grade
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 Tumor invades subepithelial connective tissue
- T2a Tumor invades superficial muscle (inner half of the detrusor muscle)
- T2b Tumor invades deep muscle (outer half of the detrusor muscle)
- 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.
- Histopathologic type of cancer
- . Types of Bladder Cancer: TCC & Other Variants. CTCA.
- . EAU Guidelines - STAGING AND CLASSIFICATION SYSTEMS. Uroweb.
- "Staging of bladder cancer ". Histopathology 74 (1): 112–134. January 2019. doi:10.1111/his.13734. PMID 30565300.
- . Bladder Cancer: Stages and Grades. Cancer.net. Approved by the Cancer.Net Editorial Board 05/2019