Features to report - bladder biopsy / TURBT

Topic Completed: 1 May 2011

Revised: 26 December 2018

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Bladder biopsy / TURBT

Monika Roychowdhury, M.D.
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Cite this page: Roychowdhury M Features to report - bladder biopsy / TURBT. website. Accessed May 26th, 2020.
Definition / general
  • 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)

  • 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

  • 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

Additional references
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