Features to report - Bladder biopsy / TURBT

Author: Monika Roychowdhury, M.D. (see Authors page)

Revised: 16 August 2016, last major update May 2011

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Bladder biopsy / TURBT

Cite this page: Features to report - Bladder biopsy / TURBT. website. Accessed April 20th, 2018.
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
Diagrams / tables

Images hosted on Nature servers:

Reporting of bladder biopsy / transurethral resection specimens

Additional references