No abstract available.
Carcinoma, Transitional Cell* ; Diagnosis* ; Kidney*

No abstract available.
Carcinoma, Transitional Cell* ; Diagnosis* ; Urinary Bladder*

Urinary cytology is increasingly accepted as a diagnostic tool in the detection and follow-up of patients with bladder cancer. However, its value is reduced by several limitations, especially by the tack of cytologic criteria specifically reflecting the morphology of low-grade urothelial neoplasm. We reviewed histologically proven 50 cases of urine cytology with emphasis on cytologic findings of benign atypia and differential findings of urothelial neoplasm according to the grade. The diagnoses included 17 benign lesions (including 5 cases of urine calculi) and 33 malignant lesions(including 28 transitional cell carcinomas. 3 squamous cell carcinomas, 1 adenocarcinoma and 1 prostate adenocarcinoma). Diagnostic accuracy was 92%. Important cytodiagnostic criteria for benign atypia and low grade malignancy were cellularity, number of cell clusters, and morphology and arrangement of urothelial cells. The cytologic findings of urothelial neoplasms according to histologic grade were relatively well correlated with the histologic findings. However, the cytologic criteria were not sufficient to readily distinguish grade I from grade II. In view of this, we think that cytologic nomenclature "low-grade" and "high-grade" is a more reliable criterion. Recognition of subtle cellular morphologic features specific for urothelial lesions(including benign or malignancy) and proper fixation, processing and staining of specimen can expand the role of urinary cytology in detection and follow-up of patients.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Diagnosis ; Humans ; Prostate ; Urinary Bladder Neoplasms

We report a case of primary transitional cell carcinoma developed in bladder vdiverticulum with brief review of literatures. Patient was a 71 year-old man who had painless gross hematuria for 10 days. Excretory urogram showe a large diverticulum in the bladder. At cystoscopy a 0.5 x 0.5cm sized papillary mass was seen on diverticular mucosa. Urine cytology revealed class V transitional cell carcinoma. At pelvic CT, metastatic evidence was not seen. We carried out partial cystectomy involving diverticulum under the diagnosis of primary transitional cell carcinoma developed in vesical diverticulum. The histopathologic diagnosis was grade III, stage A transitional cell carcinoma combining with carcinoma in situ.
Aged ; Carcinoma in Situ ; Carcinoma, Transitional Cell* ; Cystectomy ; Cystoscopy ; Diagnosis ; Diverticulum* ; Hematuria ; Humans ; Mucous Membrane ; Urinary Bladder*

PURPOSE: There is no reliable method for predicting which patient with a T1G3 bladder tumor will progress and possibly benefit from an early cystectomy. The prognostic significance of p53, pRb, and p21(waf1) expression was evaluated in patients with a T1G3 bladder tumor. MATERIALS AND METHODS: Of the 787 patients with a newly diagnosed bladder tumor, 485 were superficial. Of these patients, 57 had a T1G3 transitional cell carcinoma. Overall, a total of 30 patients were included in this study. A tumor with nuclei staining more than 10% with either p53 or p21(waf1) antibodies were defined as having altered p53 or p21(waf1) expression. The relationship between recurrence and progression and the results of immunostaining in a T1G3 bladder cancer was analyzed. RESULTS: A pathological diagnosis consisted of 14 papillary and 16 non-papillary including 2 mixed transitional cell cancers. An associated carcinoma in situ was noted in 3 patients. Of the 30 patients, 11 had a recurrence. A progression to muscle invasive bladder cancer had developed in 6 cases at a mean interval of 10.2 months. Each separate expression of p53, p21(waf1) and pRb did not correlate with tumor recurrence or progression. However, patients with combination of a positive p53 with a negative p21(waf1) and a negative pRb test had a significantly higher rate of progression to muscle invasive disease. CONCLUSIONS: A combination of altered immunostaining for a positive p53 with a negative p21(waf1) and a negative pRb test correlated with progression of a T1G3 TCCa of the bladder but not with a recurrence. Therefore, early cystectomy should be considered in a T1G3 bladder tumor with an altered expression of p53 with either p21(waf1) or with pRb.
Antibodies ; Carcinoma in Situ ; Carcinoma, Transitional Cell ; Cystectomy ; Diagnosis ; Humans ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: There is no reliable method for predicting which patient with a T1G3 bladder tumor will progress and possibly benefit from an early cystectomy. The prognostic significance of p53, pRb, and p21(waf1) expression was evaluated in patients with a T1G3 bladder tumor. MATERIALS AND METHODS: Of the 787 patients with a newly diagnosed bladder tumor, 485 were superficial. Of these patients, 57 had a T1G3 transitional cell carcinoma. Overall, a total of 30 patients were included in this study. A tumor with nuclei staining more than 10% with either p53 or p21(waf1) antibodies were defined as having altered p53 or p21(waf1) expression. The relationship between recurrence and progression and the results of immunostaining in a T1G3 bladder cancer was analyzed. RESULTS: A pathological diagnosis consisted of 14 papillary and 16 non-papillary including 2 mixed transitional cell cancers. An associated carcinoma in situ was noted in 3 patients. Of the 30 patients, 11 had a recurrence. A progression to muscle invasive bladder cancer had developed in 6 cases at a mean interval of 10.2 months. Each separate expression of p53, p21(waf1) and pRb did not correlate with tumor recurrence or progression. However, patients with combination of a positive p53 with a negative p21(waf1) and a negative pRb test had a significantly higher rate of progression to muscle invasive disease. CONCLUSIONS: A combination of altered immunostaining for a positive p53 with a negative p21(waf1) and a negative pRb test correlated with progression of a T1G3 TCCa of the bladder but not with a recurrence. Therefore, early cystectomy should be considered in a T1G3 bladder tumor with an altered expression of p53 with either p21(waf1) or with pRb.
Antibodies ; Carcinoma in Situ ; Carcinoma, Transitional Cell ; Cystectomy ; Diagnosis ; Humans ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: To assess the utility of multiphasic spiral CT for characterizing renal masses. MATERIALS AND METHODS: The study included 36 patients (53 lesions) referred for the evaluation of renal masses suspected on the basis of the results of sonography or radiography. Spiral CT of the kidneys was performed prior to and following power injection of intravenous contrast material (Optiray-320). Postcontrast imaging data were obtained and analyzed during early and late corticomedullary (20-30-second delay), nephrographic (60-70-second delay), and excretory (5-minute delay) phases. During each phase, the ability to detect renal masses was evaluated, and the ability to diagnose these masses on routine and multiphasic CT was assessed. Routine precontrast and excretory phase CT studies were performed and the usefulness of each phase for the diagnosis of renal cell carcinoma (RCC) and transitional cell carcinoma (TCC) was evaluated. RESULTS: The rates for the detection of renal masses were as follows: 94.3% on precontrast scan, 93.8% during the early corticomedulolary phase (ECMP), 98.1% during the late corticomedullary phase (LCMP), 100% during the nephrographic phase (NP), and 98.1% during the excretory phase (EP). During both routine and multiphasic CT, diagnostic accuracy was 96.2%, though for differential diagnosis, multiphasic CT was more helpful than routine CT in 4/16 cases of RCC and 2/8 cases of TCC. The highest for lesion characterization, during the LCMP in RCC, and the LCMP and NP in TCC ; for evaluation of tumor margin during the EP in both RCC and TCC ; for delineation of the renal artery, during the LCMP in both RCC and TCC ; for delineating the renal vein, during the NP in RCC, and the LCMP in TCC. CONCLUSION: For the detection and correct diagnosis oflesions, multiphasic CT was not superior to routine CT, but for the characterization of RCC and TCC, the former was helpful. The most useful phase can differ according to the kind of renal mass, and so for characterization of the mass, the most appropriate phase must be selected.
Carcinoma, Renal Cell ; Carcinoma, Transitional Cell ; Diagnosis ; Diagnosis, Differential ; Humans ; Kidney ; Radiography ; Renal Artery ; Renal Veins ; Tomography, Spiral Computed*

BACKGROUND: Pathologic grading, one of the most important prognostic factors of papillary urothelial neoplasia (PUN) of the urinary bladder, has been revised continuously. The current study focused on the analysis of interobserver agreement on PUN of the urinary bladder bet- ween 1973 WHO classification (WHO 1973) and 1998 WHO/ISUP classification. METHODS: Seventy five cases from 15 institutions were collected, and after review by Korean Society of Urogenital Pathology (KSUP), 30 cases were selected as follows; group I, WHO grade 1 and papillary urothelial neoplasm of low malignant potential by ISUP (7 cases), group II, WHO grade 2 and low-grade papillary urothelial carcinoma (16 cases), and group III, WHO grade 3 and high-grade papillary urothelial carcinoma (7 cases). Seventy five general surgical pathologists who participated in this study were asked to grade the tumors based on WHO/ISUP classification. Interobserver agreement between the participants' diagnosis and KSUP consensus diagnosis was analyzed by kappa value. RESULTS: Interobserver agreement assessed by kappa value for all diagnostic groups was very low; for group I, kappa value was -0.900893722; for group II, -0.944650025, and for group III, -0.876728996. The overall kappa value of pathology residents was better than that of practicing pathologists. CONCLUSIONS: The 1998 WHO/ ISUP classification could not be easily translated from the 1973 WHO classification and because of poor interobserver agreement, it appears that further work would be needed before it can be practically applied.
Carcinoma, Transitional Cell ; Classification* ; Consensus* ; Diagnosis ; Pathology* ; Urinary Bladder Neoplasms ; Urinary Bladder*

Since localized amyloid deposits of the ureter were first described by Lehmann in 1937, approximately 90 cases have been reported. Isolated primary amyloidosis of the ureter is a rare disease, and its diagnosis cannot be made by radiologic findings. Because of radiographic similarity to transitional cell carcinoma, these lesions are often clinically mistaken for malignancies, and nephroureterectomy is usually performed. Here, we report a case of localized ureteral amyloidosis with osseous metaplasia, which was managed successfully by renal sparing segmental resection with the bladder Boari flap.
Amyloidosis* ; Carcinoma, Transitional Cell ; Diagnosis ; Metaplasia* ; Plaque, Amyloid ; Rare Diseases ; Ureter* ; Urinary Bladder

Metastases to the skin from internal malignancy are very rare and have been reported to occur in 0.9% to 8% of patients with cancer. Particularly there are few cutaneous metastatic carcinomas from the urinary bladder and their incidence is 1% to 2% of the cutaneous metastasis. A 76-year-old man developed cutaneous metastasis six months later after the diagnosis of carcinoma of the bladder had been made. He was presented with asymptomatic erythematous indurated plaques on the left thigh and the inguinal area. This lesion was diagnosed histologically as poorly differentiated transitional cell carcinoma. We report a case of cutaneous metastasis from carcinoma of the urinary bladder showing the unusual clinical feature of an erythematous indurated plaque.
Aged ; Carcinoma, Transitional Cell ; Diagnosis ; Humans ; Incidence ; Neoplasm Metastasis* ; Skin ; Thigh ; Urinary Bladder*