Papillary Urothelial (Transitional Cell) Carcinoma

Grading / Staging

See main criteria page for grading criteria
Invasive urothelial carcinoma is graded with the same criteria as papillary carcinomas
Invasion by low grade carcinomas is rare but can occur (Toll 2012)

Although technically in situ, non-invasive papillary urothelial neoplasms are staged as pTa and are not referred to as carcinoma in situ
If possible, the extent of lamina propria / submucosa invasion should be reported
Muscularis mucosae is variable and its involvement does not affect staging
- Generally loose strands of muscle
Muscularis propria involvement is significant and should be evaluated carefully
- Dense, well defiined bundles of muscle
- Depth of muscularis propria involvement cannot be assessed in transurethral specimens
- Presence or absence of propria should be reported even if not involved
Lymphatic invasion should be confirmed by immunohistochemistry
- Pseudovascular tissue retraction is common