Urothelial dysplasia and its mimics: an update on pathologic features, differential diagnosis and clinical significance
Авторы: Lopez-Beltran A., Montironi R., Raspollini M.R., Cheng L.
DOI: 10.17650/2618-7019-2018-1-2-15-30
PDF: https://journal.oncopathology.ru/article/OP_2_18-17-32.pdf
The 2016 World Health Organization classification system for urothelial neoplasia identifies urothelial dysplasia as a premalignant lesion of the urothelium. Pathologic diagnostic criteria of urothelial dysplasia have been improved over in recent years, but low interobserver reproducibility still remains as major drawback. Follow up studies suggest that dysplasia is a marker of urothelial instability and disease progression, which can be seen in 4 % to 19 % of patients thus supporting an active clinical follow up in these patients. Differential diagnosis of urothelial dysplasia includes other flat urothelial lesions with atypia. Entities such flat urothelial hyperplasia (renamed as urothelial proliferation of uncertain malignant potential), reactive urothelial atypia and the so called atypia of unknown significance, and urothelial carcinoma in situ, should be considered. In the proper clinical context, morphologic diagnostic features on hematoxylin and eosin stained slides remains as the gold standard in the diagnosis of urothelial dysplasia. In some cases, a panel of immunohistochemical antibodies consisting of cytokeratin 20, p53 and CD44 for diagnosis may result helpful in achieving the right diagnosis. Herein, we present current pathologic diagnostic features and further the clinical significance of urothelial dysplasia. Emphasis is placed on differential diagnosis from other flat urothelial lesions with atypia.
Lopez-Beltran A.1, Montironi R.2, Raspollini M. R.3, Cheng L.4
1Department of Surgery and Pathology, Cordoba University Medical School, Cordoba, Spain;
2Institute of Pathological Anatomy and Histopathology, Polytechnic University of the Marche Region, Ancona, Italy;
3Histopathology and Molecular Diagnostics, University Hospital Careggi, Florence, Italy;
4Departments of Pathology and Laboratory Medicine, and Urology, Indiana University School of Medicine, Indianapolis, USA
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Lopez-Beltran A., Montironi R., Raspollini M. R., Cheng L. Urothelial dysplasia and its mimics: an update on pathologic features, differential diagnosis and clinical significance. Oncopathology 2018;1(2):15–30.
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