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Clinical Pathology of the Urinary Bladder

  • George Agrogiannis
  • Christos Alamanis
  • Eleni A. Karatrasoglou
  • Georgios Kousournas
  • Andreas C. Lazaris
  • Vasileios Spapis
  • Georgia-Eleni Thomopoulou
  • Dionysia N. Zouki
Chapter

Abstract

A pathologic report for transurethral resection of bladder tumor (TURBT) specimens should include the following information: layers of bladder wall represented, adequacy of material for determining T category of pTNM stage, surface denuded or ulcerated, rough tumor size, tumor configuration (papillary, flat, solid/nodular, invasive, ulcerated, undetermined), histologic type [conventional, urothelial carcinoma with/without squamous differentiation, squamous cell carcinoma, adenocarcinoma (classical or variant), small cell carcinoma, undifferentiated, mixed cell type, undetermined], histologic grade (based on tumor type), microscopic extent of tumor/invasion/pathologic staging (noninvasive flat carcinoma in situ, invasive carcinoma involving lamina propria, muscularis propria; the latter present, absent, or indeterminate), lymphovascular invasion (present, not identified, indeterminate; should be assessed away from the main tumor and only if unequivocal; often is overdiagnosed), extension in prostatic chips sampled by TURBT [involvement of prostatic urethra, prostatic acini, and ducts (by carcinoma in situ) or prostatic stroma (by invasive carcinoma)], associated epithelial lesions [urothelial papilloma (classic or inverted type), papillary urothelial neoplasm of low malignant potential, other], and additional findings (carcinoma in situ, dysplasia, metaplasia, hyperplasia, inflammation, regenerative changes, treatment-related changes, or other). Some of these features may be difficult to identify on small biopsies. It is also recommended to include clinically relevant historical information.

With regard to cystectomy (total/partial), cystoprostatectomy, and pelvic exenteration specimens, in addition to the above data, the following should be included: specimen type/procedure; tumor site and multifocality; exact tumor size; pTNM stage; surgical margin status (specify margins involved by invasive carcinoma or in situ carcinoma; if uninvolved by invasive carcinoma, specify distance from invasive carcinoma to margin); presence of tumor at margins of the urethra, ureter, paravesicular soft tissue, or pelvic soft tissue; and involvement of adjacent structures, perivesical fat, ureter (specify laterality), urethra, vagina, uterus and adnexae, pelvic sidewall (specify laterality), prostate, seminal vesicle (specify laterality), rectum, or others.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • George Agrogiannis
    • 1
  • Christos Alamanis
    • 1
  • Eleni A. Karatrasoglou
    • 1
  • Georgios Kousournas
    • 1
  • Andreas C. Lazaris
    • 1
  • Vasileios Spapis
    • 1
  • Georgia-Eleni Thomopoulou
    • 1
  • Dionysia N. Zouki
    • 1
  1. 1.AthensGreece

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