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How much do you know about benign, preneoplastic, non-invasive and invasive neoplastic lesions of the urinary bladder classified according to the 2004 WHO scheme?

Montironi R, Cheng L, Scarpelli M, Mazzucchelli R, Lopez-Beltran A - Diagn Pathol (2011)

Bottom Line: The aim of this essay is the self assessment of the level of knowledge of the 2004 WHO classification of bladder neoplasms through a series of MCQs, each associated a short commentary.This paper is directed to all who are involved with the application of this classification at the anticancer research, diagnostic, prognostic and therapeutic levels, in particular to uropathologists, urologists and oncologists.

View Article: PubMed Central - HTML - PubMed

Affiliation: Section of Pathological Anatomy, School of Medicine, Polytechnic University of the Marche Region (Ancona), Ancona, Italy. r.montironi@univpm.it

ABSTRACT
The aim of this essay is the self assessment of the level of knowledge of the 2004 WHO classification of bladder neoplasms through a series of MCQs, each associated a short commentary. This paper is directed to all who are involved with the application of this classification at the anticancer research, diagnostic, prognostic and therapeutic levels, in particular to uropathologists, urologists and oncologists.

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Related in: MedlinePlus

High-grade papillary urothelial carcinoma.
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Figure 9: High-grade papillary urothelial carcinoma.

Mentions: Tumors that in many cases would have been included in the 1973 WHO grade 2 category (upper 1/2) have a significant frequency of invasion and biologically have more in common with the grade 3 tumors. Histologically, the papillae are frequently fused forming apparent solid masses. The overall impression is one of disordered growth. The epithelium is of variable thickness and is similar to flat CIS (Figure 9). Individual cells are haphazardly arranged within the epithelium and have a generally discohesive nature. Nuclei are hyperchromatic and pleomorphic. The chromatin is dense, irregularly distributed and often clumped. Nucleoli may be single or multiple and are often prominent. Mitoses are generally frequent and may be seen at any level of the epithelium. These tumours not only have a risk of invasion but have a significant risk of recurrence and progression. For this reason the consensus was that these were better included in a high-grade category with the traditional WHO grade 3 neoplasms. The overall progression rate (to invasive carcinoma) ranges from 15% to 40%. These tumours, when noninvasive (pTa) likely all require additional intravesical therapy. Heterogeneity of grade is recognized in papillary lesions [2,8,10] and the consensus was that tumours should be graded on their worst part although this needs further study.


How much do you know about benign, preneoplastic, non-invasive and invasive neoplastic lesions of the urinary bladder classified according to the 2004 WHO scheme?

Montironi R, Cheng L, Scarpelli M, Mazzucchelli R, Lopez-Beltran A - Diagn Pathol (2011)

High-grade papillary urothelial carcinoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3107770&req=5

Figure 9: High-grade papillary urothelial carcinoma.
Mentions: Tumors that in many cases would have been included in the 1973 WHO grade 2 category (upper 1/2) have a significant frequency of invasion and biologically have more in common with the grade 3 tumors. Histologically, the papillae are frequently fused forming apparent solid masses. The overall impression is one of disordered growth. The epithelium is of variable thickness and is similar to flat CIS (Figure 9). Individual cells are haphazardly arranged within the epithelium and have a generally discohesive nature. Nuclei are hyperchromatic and pleomorphic. The chromatin is dense, irregularly distributed and often clumped. Nucleoli may be single or multiple and are often prominent. Mitoses are generally frequent and may be seen at any level of the epithelium. These tumours not only have a risk of invasion but have a significant risk of recurrence and progression. For this reason the consensus was that these were better included in a high-grade category with the traditional WHO grade 3 neoplasms. The overall progression rate (to invasive carcinoma) ranges from 15% to 40%. These tumours, when noninvasive (pTa) likely all require additional intravesical therapy. Heterogeneity of grade is recognized in papillary lesions [2,8,10] and the consensus was that tumours should be graded on their worst part although this needs further study.

Bottom Line: The aim of this essay is the self assessment of the level of knowledge of the 2004 WHO classification of bladder neoplasms through a series of MCQs, each associated a short commentary.This paper is directed to all who are involved with the application of this classification at the anticancer research, diagnostic, prognostic and therapeutic levels, in particular to uropathologists, urologists and oncologists.

View Article: PubMed Central - HTML - PubMed

Affiliation: Section of Pathological Anatomy, School of Medicine, Polytechnic University of the Marche Region (Ancona), Ancona, Italy. r.montironi@univpm.it

ABSTRACT
The aim of this essay is the self assessment of the level of knowledge of the 2004 WHO classification of bladder neoplasms through a series of MCQs, each associated a short commentary. This paper is directed to all who are involved with the application of this classification at the anticancer research, diagnostic, prognostic and therapeutic levels, in particular to uropathologists, urologists and oncologists.

Show MeSH
Related in: MedlinePlus