Transitional cell carcinoma classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Classification

Based on the growth pattern, transitional cell tumors may be classified into two subtypes:

Type Description

Papillary urothelial carcinoma

  • Have slim finger-like projections that grow from the lining of the renal pelvis or ureter into the cavity

Non-papillary urothelial carcinomas

  • Lay flat in the lining of the renal pelvis and ureter
  • They grow deeper into the layers of the wall of the renal pelvis or ureter rather than into its cavity

WHO Classification

The World Health Organization in a collaborative effort conjointly with the International Society of Urological Pathologists (ISUP) published a consensus opinion classification system for urothelial (transitional cell) tumors:[1]

 
 
Transitional cell tumors
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Infiltrating urothelial carcinoma
  • with squamous differentiation
  • with glandular differentiation
  • with trophoblastic differentiation
  • Nested
  • Microcystic
  • Micropapillary
  • Lymphoepithelioma-like
  • Lymphoma-like
  • Plasmacytoid
  • Sarcomatoid
  • Giant cell
  • Undifferentiated
 
 
 
 
 
 
 
 
 
Non-invasive urothelial carcinoma
  • Urothelial carcinoma in situ
  • High grade papillary urothelial carcinoma
  • Low grade papillary urothelial carcinoma
  • Non-invasive papillary urothelial neoplasm of low malignant potential
  • Urothelial papilloma
  • Inverted urothelial papilloma

Grading

According to the WHO grading criteria, there are two grades of transitional cell carcinoma based on the degree of cellular differentiation:

Grade Description

Low grade

  • Tumors with the least degree of cellular anaplasia compatible with a diagnosis of malignancy

High grade

  • Tumors with the most severe degrees of cellular anaplasia

References

  1. Oosterhuis JW, Schapers RF, Janssen-Heijnen ML, Pauwels RP, Newling DW, ten Kate F (2002). "Histological grading of papillary urothelial carcinoma of the bladder: prognostic value of the 1998 WHO/ISUP classification system and comparison with conventional grading systems". J Clin Pathol. 55 (12): 900–5. PMC 1769816. PMID 12461053.

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