scholarly journals Validation of grading of non-invasive urothelial carcinoma by digital pathology for routine diagnosis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Richard Colling ◽  
Hayleigh Colling ◽  
Lisa Browning ◽  
Clare Verrill
Keyword(s):  
Urothelial Carcinoma ◽  
Digital Pathology ◽  
Glass Slide ◽  
Low Grade ◽  
Non Invasive ◽  
Routine Diagnosis ◽  
Grade Versus ◽  
Glass Slides ◽  
Urothelial Bladder ◽  
Bladder Carcinomas

Abstract Background Pathological grading of non-invasive urothelial carcinoma has a direct impact upon management. This study evaluates the reproducibility of grading these tumours on glass slides and digital pathology. Methods Forty eight non-invasive urothelial bladder carcinomas were graded by three uropathologists on glass and on a digital platform using the 1973 WHO and 2004 ISUP/WHO systems. Results Consensus grades for glass and digital grading gave Cohen’s kappa scores of 0.78 (2004) and 0.82 (1973). Of 142 decisions made on the key therapeutic borderline of low grade versus high grade urothelial carcinoma (2004) by the three pathologists, 85% were in agreement. For the 1973 grading system, agreement overall was 90%. Conclusions Agreement on grading on glass slide and digital screen assessment is similar or in some cases improved, suggesting at least non-inferiority of DP for grading of non-invasive urothelial carcinoma.

scholarly journals Non-invasive papillary urothelial carcinoma, low-grade of the renal pelvis mimicking a xanthogranulomatous pyelonephritis in a male patient: A case report and review of literature

2020 ◽  
Vol 34 ◽  
pp. 205873842092572
Author(s):  
Xi Xie ◽  
Ning Wang ◽  
Yuyong Wang ◽  
Huadong He ◽  
Fanlei Kong ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Back Pain ◽  
Urothelial Carcinoma ◽  
Male Patient ◽  
Renal Pelvis ◽  
Xanthogranulomatous Pyelonephritis ◽  
Low Grade ◽  
Histopathologic Examination ◽  
Non Invasive ◽  
Papillary Urothelial Carcinoma

We report on a 31-year-old male patient with non-invasive papillary urothelial carcinoma, low grade of the renal pelvis disguised as xanthogranulomatous pyelonephritis. The only symptom of the patient was lower back pain. The initial renal-enhanced computed tomography, magnetic resonance imaging and contrast-enhanced ultrasonography showed that the right kidney had a benign lesion and this inflammatory lesion might be xanthogranulomatous pyelonephritis. A percutaneous renal biopsy was performed and histopathologic examination revealed a xanthogranulomatous pyelonephritis. Initially, we diagnosed it as xanthogranulomatous pyelonephritis and treated it with antibiotics. One and a half years later, the patient suffered from back pain again. The lesion increased significantly and a right renal pelvic lesion with retroperitoneal lymphadenopathy was considered a malignant lesion on computed tomography scan. Therefore, radical resection of right renal pelvis carcinoma was performed under retroperitoneal laparoscopy. Intraoperative frozen section was reported as right renal urothelial carcinoma with no metastasis in renal hilar lymph node. Postoperative histopathologic examination revealed non-invasive papillary urothelial carcinoma, low grade of renal pelvis.

scholarly journals LOW GRADE UROTHELIAL CARCINOMA

2018 ◽  
Vol 23 (11) ◽  
pp. 1323-1327
Author(s):  
Amjad Ali Khan ◽  
Dr. Abdul Shaheed Asghar ◽  
Muhammad Ishaq ◽  
Israr Ahmed Akhund
Keyword(s):  
Urothelial Carcinoma ◽  
Nuclear Membrane ◽  
Low Grade ◽  
High Grade ◽  
Primary Tumors ◽  
Indwelling Catheters ◽  
Medical College ◽  
Non Invasive ◽  
Urothelial Carcinomas ◽  
Cytological Features

Objectives: Urine cytology is an easy to perform non-invasive screening test forpatients who are suspected of having urinary tract malignancy. Urothelial carcinoma constitutesapproximately 90% of all primary tumors of urinary bladder.1 High-grade urothelial carcinomasare represented by well characterized cytological features. Whereas cytological features forlow-grade urothelial carcinomas show considerable overlap with features secondary to chronicinflammation, calculi, indwelling catheters or effects of intra-vesical chemotherapy.2 Thepurpose of this study is to find an appropriate set of cytological features of shed urothelial cellsthat will be useful to differentiate low-grade urothelial carcinoma cells from atypical urothelialcells secondary to non-neoplastic conditions. Study Design: Retrospective study. Setting:Charsada Teaching Hospital affiliated with Jinnah Medical College Peshawar. Period: 2010to 2015. Methods: All cases of urine and bladder washing cytology were retrieved for threediagnostic categories namely: low-grade urothelial carcinoma (LGUC), high-grade urothelialcarcinoma (HGUC), and “atypical urothelial cells”; for which histological diagnoses were alsoavailable. These cases were reviewed for cell clusters with smooth or irregular communityborders, cytoplasm texture, nucleomegaly, high nucleus to cytoplasm ratios (N/C ratio),presence of nucleoli, nuclear membrane irregularity, and chromatin texture. Results: Cellclusters with smooth borders were common in reactive changes, whereas irregular communityborders were seen in low-grade urothelial carcinomas and dyscohesive pattern was a featureof HGUC. The increase in N/C ratio ›2:1 was always associated with malignancy. The nuclearmembrane irregularity was also a strong indicator of malignancy. Cytoplasmic homogeneityand nuclear hyperchromasia were more prominent and consistently seen in high-gradeurothelial carcinomas. Conclusions: The study showed that nuclear membrane irregularity,nucleomegaly and high N/C ratio of › 2:1 were the most consistent features found in LGUC.These features can be used with high certainty to differentiate LGUC (malignant) from atypicalurothelial cells (non-neoplastic).

Clinicopathological study of urothelial neoplasms in urinary bladder with special reference to expression of Her2/neu and Ki-67 in malignant lesions

2021 ◽  
Vol 8 (3) ◽  
pp. 378-385
Author(s):  
Sarmila Sen ◽  
Ayesha Abid ◽  
Ranjana Bandyopadhyay
Keyword(s):  
Urothelial Carcinoma ◽  
Histological Grade ◽  
Tertiary Care ◽  
Population Group ◽  
Low Grade ◽  
Care Hospital ◽  
Ki 67 ◽  
Cross Sectional ◽  
Non Invasive ◽  
Urothelial Carcinomas

Urothelial carcinomas are the fourth most common tumors worldwide. Studies have shown that Her2/neu is associated with increased tumour grade and Ki‐67 is related to tumour recurrence and stage progression. As no such study has been undertaken is this region, the present study was aimed to establish Her2/neu and Ki-67 as novel prognostic markers of urothelial neoplasms.: To evaluate the clinical profile of urothelial neoplasms and correlate the expression of Her2/neu and Ki-67 in urothelial carcinomas.Observational and cross-sectional study (January 2018-May 2019) in a tertiary care hospital in Eastern India.: 40 specimens of urothelial neoplasms were studied. Clinical history of patients was collected. Microscopic examination was done to assess tumour stage and histological grade. Immunohistochemistry with Her2/neu and Ki-67 was performed.: Statistical Package for the Social Sciences SPSS (version 20.0, IBM, Chicago, IL, USA) for windows software.: 8 cases were diagnosed as low grade non-invasive urothelial carcinoma, 31 cases as infiltrating urothelial carcinoma and 1 case as papillary urothelial neoplasm of low malignant potential (PUNLMP). 96.8% of infiltrating carcinomas and 87.5% of low grade non-invasive carcinomas showed Ki-67 positivity. Moderate-to-strong Her2/neu overexpression (2+ or 3+) was observed in only 21% of the cases.: The expression of Ki-67 increased with increase in the grade of the tumour which was suggestive of the prognostic importance of Ki-67. Her2/neu positivity was seen in infiltrating cases. No significant association between the tumor grade and Her2/neu expression, indicated the need for further studies with a larger population group.

Utility of GATA-3 and Cytokeratin 5/6 Immunostains in Separating Condyloma Acuminatum Arising in the Urinary Tract From Non-Invasive Papillary Urothelial Carcinoma

2021 ◽  
pp. 106689692110522
Author(s):  
Diego Montoya-Cerrillo ◽  
Laurence M. Briski ◽  
Merce Jorda ◽  
Oleksandr N. Kryvenko
Keyword(s):  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Condylomata Acuminata ◽  
Condyloma Acuminatum ◽  
Low Risk ◽  
Low Grade ◽  
High Grade ◽  
Non Invasive ◽  
Urothelial Carcinomas ◽  
Papillary Urothelial Carcinoma

Background Condyloma acuminatum is a squamous epithelial lesion which uncommonly involves the urinary tract. In this location, non-invasive papillary urothelial carcinoma constitutes one of the main differential diagnoses with significant prognostic and therapeutic implications. To date, no ancillary immunohistochemical stain has been described to differentiate these two entities. We assess the utility of cytokeratin 5/6 (CK5/6) and GATA-3 immunohistochemistry in distinguishing condyloma acuminatum from non-invasive papillary urothelial carcinoma. Design We reviewed 9 condylomata acuminata involving the urinary tract, 12 low-grade and 8 high-grade non-invasive papillary urothelial carcinomas. CK5/6 immunostaining was performed in all cases. GATA-3 immunostaining and low-risk human papilloma virus (HPV) chromogenic in situ hybridization was performed in all condyloma cases and 2 urothelial carcinomas with squamous differentiation. Results 8/9 condylomata acuminata were positive for low-risk HPV. All condylomata acuminata exhibited strong full-thickness cytoplasmic staining for CK5/6. In 10 of 12 low-grade non-invasive papillary urothelial carcinomas, CK5/6 expression was continuous and limited to the basal cell layer, while it was patchy and limited to the basal cell layer in all 8 high-grade non-invasive papillary urothelial carcinomas. Two low-grade non-invasive papillary urothelial carcinomas showed focal full-thickness CK5/6 expression in the areas of squamous differentiation. These 2 cases were negative for low-risk HPV. GATA-3 immunostaining was positive in all condylomata acuminata. Conclusions CK5/6 immunostaining is a useful and simple tool that can help separate low-grade and high-grade non-invasive papillary urothelial carcinomas from condyloma acuminatum involving the urothelium-lined organs. GATA-3 has no discriminatory role between condyloma acuminatum and papillary urothelial carcinomas.

Concordance between digital pathology and light microscopy in general surgical pathology: a pilot study of 100 cases

2014 ◽  
Vol 67 (12) ◽  
pp. 1052-1055 ◽  
Author(s):  
Joseph P Houghton ◽  
Aaron J Ervine ◽  
Sarah L Kenny ◽  
Paul J Kelly ◽  
Seamus S Napier ◽  
...  
Keyword(s):  
Pilot Study ◽  
Light Microscopy ◽  
Digital Images ◽  
Digital Pathology ◽  
Glass Slide ◽  
Clinical Consequence ◽  
Histopathological Diagnosis ◽  
Original Diagnosis ◽  
Glass Slides ◽  
Viable Method

Aim(1) A pilot study to determine the accuracy of interpretation of whole slide digital images in a broad range of general histopathology cases of graded complexity. (2) To survey the participating histopathologists with regard to acceptability of digital pathology.Materials and methodsGlass slides of 100 biopsies and minor resections were digitally scanned in their entirety, producing digital slides. These cases had been diagnosed by light microscopy at least 1 year previously and were subsequently reassessed by the original reporting pathologist (who was blinded to their original diagnosis) using digital pathology. The digital pathology-based diagnosis was compared with the original glass slide diagnosis and classified as concordant, slightly discordant (without clinical consequence) or discordant. The participants were surveyed at the end of the study.ResultsThere was concordance between the original light microscopy diagnosis and digital pathology-based diagnosis in 95 of the 100 cases while the remaining 5 cases showed only slight discordance (with no clinical consequence). None of the cases were categorised as discordant. Participants had mixed experiences using digital pathology technology.ConclusionsIn the broad range of cases we examined, digital pathology is a safe and viable method of making a primary histopathological diagnosis.

scholarly journals Case Report: Large nested variant urothelial carcinoma –invasive malignancy masquerading as low grade disease

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 314
Author(s):  
Andrew Keller ◽  
Ai Jye Lim ◽  
Ahmad Ali
Keyword(s):  
Case Report ◽  
Urothelial Carcinoma ◽  
Urothelial Cancer ◽  
Muscularis Propria ◽  
Low Grade ◽  
Clinical Recurrence ◽  
Non Invasive ◽  
Operative Specimen ◽  
Cytological Features ◽  
Nested Variant

IntroductionThe large nested variant of urothelial carcinoma (LNVUC) is a newly described and rare subtype of urothelial carcinoma. It is characterised by bland cytological features and a large nested architecture similar in appearance to low grade urothelial carcinoma with an inverted growth pattern. To date only 23 cases in a single series have been described.Case ReportWe describe the case of a 59 year old male with LNVUC whose tumour was initially misdiagnosed as a non-invasive low grade urothelial carcinoma. At a subsequent re-resection, his tumour was correctly re-classified as LNVUC with extensive invasion of the muscularis propria. Radical cystectomy and formation of an ileal conduit was performed. His operative specimen revealed invasion of prostatic stroma and perivesical fat, with all surgical margins clear. He is currently free from clinical recurrence 12 months after his cystectomy.ConclusionLNVUC is a newly described and rare urothelial carcinoma subtype. It characteristically possesses bland cytological features and may mimic low grade urothelial cancer. Despite its bland appearance it behaves aggressively with invasion, metastasis and death being common.

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