Carcinoma, Transitional Cell ; pathology ; Humans ; Neoplasm Grading ; Urologic Neoplasms ; pathology

Humans ; Carcinoma, Small Cell/pathology* ; Urinary Tract/pathology* ; Carcinoma, Neuroendocrine/pathology* ; Kidney Neoplasms/pathology* ; Carcinoma, Transitional Cell/pathology* ; Ureter/pathology*

Animals ; Carcinoma, Large Cell ; physiopathology ; Carcinoma, Transitional Cell ; classification ; Humans ; Urologic Neoplasms ; classification ; Urothelium ; metabolism ; pathology

Humans ; Urinary Bladder Neoplasms/pathology* ; Carcinoma, Transitional Cell/pathology* ; Genetic Markers ; Biomarkers, Tumor/genetics* ; Urothelium/pathology*

Transforming growth factor-beta (TGF-beta), a pleiotropic growth factor, is a potent inhibitor of cellular proliferation in cells of epithelial origin. Recently, it has been suggested that a loss of sensitivity to TGF-beta through a loss of expression of TGF-beta receptors T beta R-I and T beta R-II--is associated with tumor initiation and progression. Therefore, to investigate the relationship between TGF-beta receptors expression and carcinogenesis of bladder TCC, this study examined the expression of T beta R-I and T beta R-II in 46 bladder TCC patients using immunohistochemistry. Since histopathological grade is a widely accepted marker of prognosis, the results were compared in relation to the three grades of bladder TCC. The results demonstrated that the loss of TGF-beta receptors expression is associated with increasing histopathological grades of bladder TCC. Specifically, both T beta R-I and T beta R-II were readily detected in all 10 normal bladder mucosa specimens. Likewise, all 6 specimens of grade I TCC samples expressed high levels of both TGF-beta receptors. However, among grade II TCC samples, T beta R-I and T beta R-II were detected in 78% and 89%, respectively: among grade III TCC samples, T beta R-I and T beta R-II were detected in 45% and 41%, respectively. These results suggested that loss of sensitivity to TGF-beta may play a role in the progression of TCC from low to high grade disease.
Adult ; Aged ; Bladder Neoplasms/pathology* ; Bladder Neoplasms/metabolism* ; Carcinoma, Transitional Cell/pathology* ; Carcinoma, Transitional Cell/metabolism* ; Human ; Middle Age ; Receptors, Transforming Growth Factor beta/metabolism* ; Reference Values

We report a case of primary small cell carcinoma of the ureter with squamous cell and transitional cell carcinomatous components associated with ureteral stone, which is unique in that the patient has remained free of tumor recurrence for 36 months after the surgery without adjuvant chemotherapy or radiotherapy. A 60-yr-old man presented himself with a right flank pain. Computed tomography revealed an ill-defined mass and a stone in the lower one third of the right ureter, and hydronephroureterosis above the stone-impacted site. The patient underwent right nephroureterectomy and stone removal. Upon gross examination, a 3.8 x 1.8 x 1.2 cm white and partly yellow mass was noted in the anterior part of the ureter, resulting in indentation of the ureteral lumen on the posterior side. Light microscopic examination revealed that the mass was mainly composed of small cell carcinoma, and partly squamous cell and transitional cell carcinomatous components. The overlying ureteral mucosa and renal pelvis also contained multifocal dysplastic transitional epithelium and transitional cell carcinoma in situ. There was no vascular invasion, and the surgical margins were free of tumor. The small cell carcinomatous component was positive for chromogranin, neuron specific enolase, synaptophysin, and pancytokeratin but negative for high molecular-weight cytokeratin (K-903) by immunohistochemistry.
Carcinoma, Small Cell/*pathology ; Carcinoma, Transitional Cell/*pathology ; Case Report ; Human ; Male ; Middle Age ; Neoplasms, Squamous Cell/*pathology ; Tomography, X-Ray Computed ; Ureteral Calculi/*pathology ; Ureteral Neoplasms/*pathology

Adenocarcinoma ; pathology ; Carcinoma, Squamous Cell ; pathology ; Carcinoma, Transitional Cell ; pathology ; Female ; Humans ; Kidney Neoplasms ; pathology ; Kidney Pelvis ; pathology ; Middle Aged ; Neoplasms, Multiple Primary ; pathology

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*

We report a case of simultaneous contralateral renal transitional cell carcinoma and renal cell carcinoma. A 63-yr-old male presented with hematuria. He was diagnosed with left renal pelvis tumor and contralateral renal cell carcinoma. Subsequently, the patient received left nephrectomy and paraaortic lymphadenectomy (transitional cell carcinoma, pT3N2M0). Post-operatively, chemotherapy of renal pelvis tumor and angioinfarction of contralateral renal cell carcinoma are being considered. We believe that management planning should be individualized in such cases.
Carcinoma, Renal Cell/pathology* ; Carcinoma, Transitional Cell/pathology* ; Case Report ; Human ; Kidney Neoplasms/pathology* ; Male ; Middle Age ; Neoplasms, Multiple Primary/pathology*

PURPOSE: The routine follow-up study protocol after Bacillus Calmette-Guerin (BCG) therapy for high risk superficial transitional cell cancer (TCC) of the bladder is voided urine cytology and cystoscopy every 3 months for the first 2 years. If abnormal findings are shown at those tests, then bladder biopsy is needed. We evaluated the value and necessity of routine biopsy with cytology and cystoscopy as screening tools for the purpose of determining which patients should undergo biopsy. MATERIALS AND METHODS: The routine biopsy records of 67 patients with superficial TCC of the bladder who received BCG therapy were reviewed. The pathology findings before BCG therapy, along with the follow-up cystoscopy, cytology and biopsy results after BCG therapy, were noted. RESULTS: The cystoscopic and/or cytologic findings were abnormal in 51 (76.1%) cases. TCC of bladder was found on biopsy after BCG therapy in 25 (37.3%) of all 67 cases. All of the 16 cases with normal cystoscopy and cytology findings represent negative biopsy results. Overall, the positive biopsy rates were 17.6% (3 of 17) after treatment for multiple Ta lesions, 41.9% (13 of 31) after treatment for multiple T1 lesions, and 47.4% (9 of 19) after treatment for carcinoma in situ (CIS). CONCLUSIONS: Patients with superficial TCC of the bladder who have negative cystoscopy and urine cytology results can safely be spared routine transurethral bladder biopsy with its associated morbidity. However, patients with T1 and CIS are very likely to have persistent abnormal cytologic or abnormal cystoscopic findings, and this warrants investigation with biopsy and these patients may benefit from routine scheduled biopsy.
Bacillus* ; Biopsy* ; Carcinoma in Situ ; Carcinoma, Transitional Cell* ; Cystoscopy ; Follow-Up Studies ; Humans ; Mass Screening ; Mycobacterium bovis ; Pathology ; Urinary Bladder*