By Jonathan I. Epstein
Written through 3 eminent specialists in urologic pathology, this quantity is a pragmatic, thorough, and fantastically illustrated advisor to bladder biopsy interpretation. It starts with basic anatomy and versions of ordinary histology after which presents entire, present details on all lesions, tumors, and tumor-like lesions. Tables are integrated to help in differential analysis. assurance comprises the most recent international well-being association and foreign Society for Urologic Pathology class procedure for bladder urothelial neoplasms. A bound-in CD-ROM comprises over 800 full-color photos protecting the whole spectrum of universal and infrequent lesions, and incorporates a quiz mode that's excellent for board examination coaching.
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Additional info for Bladder Biopsy Interpretation (Biopsy Interpretation Series)
34) (efigs 333-398). Architecturally, the cells are irregularly oriented and disorganized. Cellular pleomorphism ranges from moderate to marked. The nuclear chromatin tends to be clumped and nucleoli may be prominent and irregular. Mitotic figures, including atypical forms, may be frequently seen at all levels of the urothelium. A single papillary urothelial neoplasm may contain a spectrum of cytologic and architectural abnormalities. In tumors with variable histology, the tumor should be graded according to the highest grade, although current practice is to ignore minuscule areas of higher grade tumor.
1. Inverted growth pattern of papillary urothelial neoplasm of low malignant potential. FIG. 2. 1). 65 59 60 FIG. 3. Noninvasive low-grade papillary urothelial carcinoma with inverted growth pattern. FIG. 4. 3). 66 60 61 FIG. 5. Noninvasive low-grade papillary urothelial carcinoma with inverted growth pattern. Note true papillary frond formation and mitotic figure. FIG. 6. Noninvasive low-grade papillary urothelial carcinoma with inverted growth pattern. Note true papillary frond formation. 1. Differences between inverted papilloma and urothelial carcinoma with inverted 61 62 papilloma-like growth Urothelial carcinoma with inverted papilloma-like Inverted papilloma growth Surface Smooth dome-shaped or focally Variable, usually exophytic papillary lesion exophytic, cytologically unremarkable, usually intact surface Growth Endophytic, expansile, sharply delineated Endophytic; may coexist with â verrucous pattern lesion carcinoma-likeâ inverted growth pattern; lesional circumscription variable Ramifying cords and trabeculae of even Ramifying cords and trabeculae with irregularity of width width and with transition into solid areas Destructive invasion of lamina propria or Possible invasion into lamina propria or muscle muscularis propria absent by definition Cytologic Orderly polarized cells with tendency to Maturation, spindling, or palisading minimal to absent features spindle and palisade at the periphery Diffuse, severe cytologic atypia absent Cytologic features are grade dependent (urothelial carcinoma, low grade or high grade) Biologic Benign, recurrences none Recur (usually new occurrences) or progress (depends potential on grade and stage) INVERTED UROTHELIAL PAPILLOMA This is a benign tumor of the urinary bladder comprising less than 1% of urothelial neoplasms.
51 52 FIG. 29. Noninvasive high-grade papillary urothelial carcinoma. 56 FIG. 30. Noninvasive high-grade papillary urothelial carcinoma. 52 53 FIG. 31. Noninvasive high-grade papillary urothelial carcinoma. 57 FIG. 32. Noninvasive high-grade papillary urothelial carcinoma. 53 54 FIG. 33. Noninvasive high-grade papillary urothelial carcinoma. 58 FIG. 34. Noninvasive high-grade papillary urothelial carcinoma. Papillary Urothelial Neoplasms: Early Controversy One of the earliest articles in which the WHO(2003)/ISUP system was applied led to controversy regarding the classification system (15).
Bladder Biopsy Interpretation (Biopsy Interpretation Series) by Jonathan I. Epstein