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Bladder

Miscellaneous

Features to report - Bladder biopsy / TURBT

Reviewer: Monika Roychowdhury, M.D., University of Minnesota Medical Center (see Reviewers page)
Revised: 3 July 2011, last major update May 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

General
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● Editor’s note
● Mandatory / optional are for accreditation purposes by the American College of Surgeons Committee on Cancer
● Note: some of these features may be difficult to identify on small biopsies

● Recommended to include clinically relevant historical information (Virchows Arch 2004;445:103)

Mandatory:
● None

Optional / recommended:
● Site of tumor / procedure
● Tumor size
● Tumor histologic type
● Tumor histologic grade
● Macroscopic pattern of growth (papillary, flat, invasive)
● Type of invasion: broad spread or tentacular (like tentacles)
● Depth of invasion
● Layers of wall represented (muscularis propria identified or not)
● Denuded/ulcerated
● Involvement of prostate
● Additional findings: carcinoma in situ, dysplasia, hyperplasia, inflammation, normal, other

Tumor:
● Histologic type - urothelial carcinoma with/without squamous differentiation, squamous cell carcinoma (classical or variant), adenocarcinoma (classical or variant), small cell carcinoma, undifferentiated, mixed cell type, undetermined
● Histologic grade – based on tumor type
● Tumor configuration – papillary, flat, nodule, invasive, ulcerated, undetermined
● Invasion assessment – detrusor muscle (muscularis propria) present, absent or indeterminate
● Lymphovascular invasion – present, not identified, indeterminate, should be assessed away from the main tumor (only if unequivocal, often is overdiagnosed, Mod Pathol 1990;3:83)
● Microscopic extent of tumor – noninvasive flat carcinoma in situ, involves lamina propria, involves muscularis propria
● Extension in prostatic chips sampled by TURBT - involvement of prostatic urethra, prostatic and acini 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
● Additional findings – carcinoma in situ, dysplasia, metaplasia, hyperplasia, inflammation, regenerative changes, treatment related changes, other

● Table

● References: Mod Pathol 2009;22 Suppl 2:S70

End of Bladder > Miscellaneous > Features to report - Bladder biopsy / TURBT

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