Bladder, ureter & renal pelvis
General
Features to report


Topic Completed: 1 May 2011

Minor changes: 11 June 2020

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PubMed Search: Bladder tumor features to report


Monika Roychowdhury, M.D.
Page views in 2020 to date: 75
Cite this page: Roychowdhury M Features to report. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bladderreport.html. Accessed August 7th, 2020.
Definition / general
Features to report: cystectomy, cystoprostatectomy, pelvic exenteration
Mandatory:
  • Specimen type / procedure
  • Tumor size
  • Tumor histologic type
  • Tumor histologic grade
  • Adequacy of specimen to determine muscularis propria invasion (muscularis propria found / not found / indeterminate)
  • Lymphovascular invasion (present / absent / indeterminate)
  • Pathologic stage (includes depth of invasion) (pTNM)
  • Regional lymph nodes: either no nodes submitted or found, number examined / cannot be determined (explain), number involved (any size) / cannot be determined (explain); optional - extranodal extension of tumor
  • Surgical margins: 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 urethra, ureter, paravesicular soft tissue or pelvic soft tissue
  • Involvement of adjacent structures: perivesical fat, ureter (specify laterality), urethra, vagina, uterus and adnexae, pelvic sidewall (specify laterality), prostate, seminal vesicle (specify laterality), rectum, other
  • Additional epithelial lesions: papilloma, inverted papilloma, papillary neoplasm of low malignant potential

Optional but recommended:
  • Site of tumor
  • Tumor configuration (papillary, solid / nodule, flat, ulcerated, indeterminate)
  • Additional findings: multifocality, carcinoma in situ, dysplasia, hyperplasia, inflammation, therapy related changes, keratinizing squamous metaplasia, intestinal metaplasia, inflammation / regenerative changes, cystitis cystica glandularis, urothelial carcinoma involving urethra / prostatic ducts and acini (use protocol for carcinoma of urethra)
  • References: Mod Pathol 2009;22:S70, Arch Pathol Lab Med 2003;127:1263
Features to report: bladder biopsy / TURBT
    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
    • References: Mod Pathol 2009;22:S70
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