Terminology Historic

Historically, terminology describing urinary tract lesions has been almost as confusing as lymphoma categories. A popular histologic grading system divides the neoplasms into three groups: Grade I (low), Grade II (medium), and Grade III (high). In those systems that add a fourth grade, equivalence may be accomplished by placing papillomas in the Grade I category, the low grade lesions in Grade II, etc. Including papillomas with Grade I lesions may be justified by the evidence that these benign appearing papil-lomas may progress to higher grade carcinomas, or at least identify the patient as at risk for subsequent development of a high grade lesion. From a patient management standpoint, all papillary lesions of the urinary bladder can be considered cancerous. However, the current general opinion, that the most treacherous lesions are the high grade sessile (flat) lesions, capable of quickly invading, makes the low grade papillary lesions less noteworthy than previously considered. Therefore, cytopathologists may prefer to divide the neoplasms of the urothelium simply into low and high grade.

3. Grading Urothelial Neoplasms Table 3. The WHO/ISUP Consensus Classification

Normal

May include cases formerly diagnosed as "mild dysplasia" Hyperplasia Flat hyperplasia Papillary hyperplasia Flat lesions with atypia

Reactive (inflammatory) atypia Atypia of unknown significance Dysplasia (low grade intraurothelial neoplasia) Carcinoma in situ (high grade intraurothelial neoplasia) Papillary neoplasms

Papilloma—Inverted papilloma

Papillary neoplasm of low malignant potential (PUNLMP) Papillary carcinoma, low grade Papillary carcinoma, high grade Invasive neoplasms

Lamina propria invasion

Muscularis propria (detrusor muscle) invasion

Was this article helpful?

0 0
10 Ways To Fight Off Cancer

10 Ways To Fight Off Cancer

Learning About 10 Ways Fight Off Cancer Can Have Amazing Benefits For Your Life The Best Tips On How To Keep This Killer At Bay Discovering that you or a loved one has cancer can be utterly terrifying. All the same, once you comprehend the causes of cancer and learn how to reverse those causes, you or your loved one may have more than a fighting chance of beating out cancer.

Get My Free Ebook


Post a comment