Non-invasive papillary urothelial carcinoma

Non-invasive papillary urothelial carcinoma 

Updated: 01/26/2021

© Jun Wang, MD, PhD

General features
  • More common in male, older population
  • Commonly multifocal
Clinical presentations
  • Hematuria
  • Atypical cells in urine
Key morphological features
  • Papillary growth
  • Increased cellular proliferation exceeding the thickness of normal urothelium (> 7 layers)
  • Architectural atypia such as fusion of papillae
  • NO invasion
  • Graded by cytological atypia
Low grade: slightly disorganized architecture and mild variation in nuclear shape, size, darkness, etc
High grade: moderate to marked architectural and cytological pleomorphism (great variation of nuclear shape, size, darkness, brisk mitosis, etc)
Genetics
  • Low grade: no specific findings, including FGFR3
  • High grade: aneuploidy, p53, Her2, EGFR, loss of p21Waf1 or p27kip1
Treatment
  • Low grade: surgery
  • High grade: surgery, chemotherapy, radiation therapy



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