Morphological diagnosis of urothelial neoplasms: Figure 1

Montironi, Rodolfo; Mazzucchelli, Roberta; Scarpelli, Marina; López-Beltrán, Antonio; Liu, Cheng

doi:10.1136/jcp.2007.049312

Cited by 59 publications

(37 citation statements)

References 46 publications

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“…If such cells form more than a single layer, the CK20 antigen might be also expressed (46). Both, Ki-67 as well as CK20 staining were useful markers for differentiation between dysplasia on one hand, non-neoplastic hyperplasia and/or reactive urothelium atypia on other hand (42).…”

Section: Discussionmentioning

confidence: 99%

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Immunohistochemical characterization of urothelial carcinoma

Rajčáni¹,

Kajo²,

Adamkov³

et al. 2013

BLL

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From the archive of BB Biocyt company, 32 urinary bladder carcinomas (urothelium carcinomas, UC) and 7 cases of chronic cystitis were selected and examined in semiserial sections for the following antigens: 1) cell proliferation marker Ki-67 (expressed in the nuclei), 2) cell cycle regulator p16/INK4a polypeptide (expressed in the cytoplasm and nuclei), 3) urothelium marker p63 (expressed in the nuclei), 4) cytokeratin 7 (CK7). 5) cytokeratin 20 (CK20) and 6) high molecular weight cytokeratin (HMWCK). Invasive urothelium carcinomas showing a high grade dysplasia (invasive HG UC) comprised over the half (20 out of 32) of the investigated tumours. Microinvasion to lamina propria (seen in three HG papillary carcinomas) was regarded as an early infi ltration even when the position of muscular layer could not be determined. Classical invasion across the urinary bladder wall and/or to surrounding tissues was found in 17 cases of low-differentiated HG UCs. The rest (9 out of 32 neoplasms) were either non-invasive papillary carcinomas of high (non-invasive HG UC, 5 cases) or low malignant potential (noninvasive LG UC, 4 cases). Finally, 3 cases were papillary urothelium neoplasms of low malignant potential (PUNLMP). HMWCK was present in all invasive tumours, whereas the frequency of other urothelium markers ranged from 65 to 88 %. Nevertheless, at least two markers were expressed in each invasive tumour. Staining for Ki-67 antigen was positive in over 50 % of the nuclei of HG UCs, while in the LG UCs, the frequency of positive Ki-67 staining did not exceed 25 %. In PUNLMP, the positive rate of Ki-67 stained dysplastic cells was below 10 %. The staining for p16 antigen did not correlate with the degree of dysplasia within urothelium tumours. For routine diagnostic, we recommend to combine the Ki-67 staining with detection of HMWCK. In cases of chronic cystitis, which developed urothelial hyperplasia and/or squamous metaplasia, the presence of p63 antigen was a relevant marker confi rming the urothelial origin of the altered transitional cells (Tab. 6, Fig. 4, Ref. 69)

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Section: Discussionmentioning

confidence: 99%

“…1). These criteria of dysplasia have been more precisely defi ned (41,42,46,68), since PUNLMP should be distinguished from LG UC on one hand, as well as from urothelium hyperplasia on other hand.…”

mentioning

confidence: 99%

Immunohistochemical characterization of urothelial carcinoma

Rajčáni¹,

Kajo²,

Adamkov³

et al. 2013

BLL

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“…Diagnostic errors arose mainly from a lack of clinical information, and a failure to include previous pathology reports and radiographic studies. The diagnostic discordances in interpreting and defining the histotype and grade of urothelial carcinoma often reflected a reluctance to use the newer classification systems; whereas the discordance in tumor stage arose from a poor knowledge of the staging guidelines, inability to identify muscularis propria invasion and the scarce use of the immune markers cytokeratin 7 and 20 [46].…”

Section: Discussionmentioning

confidence: 99%

“…The main causes of discordance in the prostate specimens obtained through TURP were problems in assessing the histological grade of intraepithelial prostatic neoplasia (PIN) (low-grade vs high-grade PIN; high-grade PIN vs microinvasive PCA), and in assessing the Gleason score histologic grading (Montironi NCPU 2007) [45] (Montironi JCP 2007) [46]. The diagnosis of low-grade PIN should not be reported at all (Bostwick USP 1997) [37], whereas a diagnosis of high-grade PIN suggests that the patient should undergo regular follow-up to detect the possible development of prostate cancer (Bostwick USP 1997) [37].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic 'Errors' in a Single Urogenital Pathology Unit

Cardillo¹

2008

TOPATJ

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Abstract:To understand better the factors that contribute to diagnostic errors in urogenital pathology units, as part of our ongoing research into urogenital cancers, from a consecutive series of 6304 histologic reports for the years 2003 to 2006 we selected for review those containing more than one evident error. We reviewed 1746 urogenital histopathologic diagnoses, 1459 (83.56%) referred to biopsies and 287 (16.43%) to surgical specimens. Of the 1746 reports reviewed, 1643 diagnoses (94.10%) were in agreement and 103 (5.89%) in disagreement with the reviewer's rating. Among these 103 diagnoses, 77 (70.75%) had justifiable and 27 (26.21%) unjustifiable discordances. Of these 27 discordances, 23 were unjustifiable discordances containing errors with consequences that affected patient management. The poor diagnostic efficiency found in a single anatomopathological unit raises concern and suggests considerable room for improvement. Efficiency could be substantially improved if pathological services strictly applied the existing international measures for quality control.

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“…Increasing size of nuclei, with a globally preserved architecture and increasing cellular density are common. Increasing vascularisation has been described in the submucosa (14,15). Several cases of RA with mitosis have been described.…”

Section: Flat Lesions With Atypiamentioning

confidence: 99%

Fluorescence diagnosis and flat lesions of urothelium: New challenges for pathologists and urologists (Review)

Compérat¹

2009

Oncol Rep

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Abstract. Bladder cancer is a common malignancy. Recurrence rate and progression vary greatly depending on factors such as tumor multiplicity, size, previous recurrence rates, tumor stage, tumor grade and the presence of carcinoma in situ. Treatment is expensive, recent studies demonstrated that superficial bladder cancer is a major economic burden. It is necessary to establish new kinds of techniques to improve diagnosis, therapy and follow-up, such as fluorescence diagnosis, without adding significant risk of complications. As urologists have a better sight of bladder lesions with fluorescence diagnosis, pathologists will be asked in the future to evaluate more frequently flat lesions, which up to now would not have been a matter of concern. For several reasons it is very important to have accurate and precise definitions of these flat lesions. First to permit uniform treatment of large groups of patients and second to see in large cohorts the evolution and natural history of several flat lesions, not always well known up to now. The aim of the study was to review the most important flat lesions, to demonstrate the difficulty of classifying several lesions, to introduce to urologists the new problems linked to FD and to suggest new models for accurate analysis. How far can we go in our answer as pathologists and how will it change the patient management?

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Morphological diagnosis of urothelial neoplasms: Figure 1

Cited by 59 publications

References 46 publications

Immunohistochemical characterization of urothelial carcinoma

Immunohistochemical characterization of urothelial carcinoma

Diagnostic 'Errors' in a Single Urogenital Pathology Unit

Fluorescence diagnosis and flat lesions of urothelium: New challenges for pathologists and urologists (Review)

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