Transitional cell carcinoma classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2] Ramyar Ghandriz MD [3]

Overview

Based on the growth pattern, transitional cell carcinoma may be classified into either papillary urothelial carcinoma or non-papillary urothelial carcinoma. Transitional cell carcinoma may be classified according to World Health Organization in a collaborative effort conjointly with the International Society of Urological Pathologists (ISUP) into two groups: infiltrating urothelial carcinomas and non-invasive urothelial carcinomas.Based on the degree of cellular differentiation , transitional cell carcinoma may be classified into two grades: low grade and high grade.

Classification

Based on the growth pattern, transitional cell carcinoma may be classified into two subtypes:^[1]


Type	Description

Papillary urothelial carcinoma	Slim finger-like projections that grow from the lining of the renal pelvis or ureter into the cavity
Non-papillary urothelial carcinoma	Sessile or nodular tumors They grow deeper into the layers of the wall of the renal pelvis or ureter rather than into its cavity

WHO Classification

Transitional cell carcinomas may be classified according to World Health Organization in a collaborative effort conjointly with the International Society of Urological Pathologists (ISUP) into two groups: infiltrating urothelial carcinomas and non-invasive urothelial carcinomas:^[2]

Transitional cell tumors

Infiltrating urothelial carcinoma

with squamous differentiation
with glandular differentiation
with trophoblastic differentiation
Nested
Microcystic
Micropapillary
Lymphoepithelioma-like
Lymphoma-like
Plasmacytoid
Sarcomatoid
Giant cell
Undifferentiated

Non-invasive urothelial carcinoma

Urothelial carcinoma in situ
High grade papillary urothelial carcinoma
Low grade papillary urothelial carcinoma
Non-invasive papillary urothelial neoplasm of low malignant potential
Urothelial papilloma
Inverted urothelial papilloma

Grading

According to the WHO grading criteria, there are two grades of transitional cell carcinoma based on the degree of cellular differentiation:


Grade	Description

Low grade	Tumors with the least degree of cellular anaplasia Rarely invades the muscular wall of the bladder or spreads to other parts of the body Often recurs after treatment
High grade	Tumors with the most severe degrees of cellular anaplasia Commonly recurs and also has a strong tendency to invade the muscular wall of the bladder and spread to other parts of the body High grade transitional cell carcinoma is much more likely to result in death

References

↑ Leder, R A; Dunnick, N R (1990). “Transitional cell carcinoma of the pelvicalices and ureter”. American Journal of Roentgenology. 155 (4): 713–722. doi:10.2214/ajr.155.4.2119098. ISSN 0361-803X.
↑ Oosterhuis JW, Schapers RF, Janssen-Heijnen ML, Pauwels RP, Newling DW, ten Kate F (2002). “Histological grading of papillary urothelial carcinoma of the bladder: prognostic value of the 1998 WHO/ISUP classification system and comparison with conventional grading systems”. J Clin Pathol. 55 (12): 900–5. PMC 1769816. PMID 12461053.

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[LederDunnick1990-1] Leder, R A; Dunnick, N R (1990). “Transitional cell carcinoma of the pelvicalices and ureter”. American Journal of Roentgenology. 155 (4): 713–722. doi:10.2214/ajr.155.4.2119098. ISSN 0361-803X.

[pmid12461053-2] Oosterhuis JW, Schapers RF, Janssen-Heijnen ML, Pauwels RP, Newling DW, ten Kate F (2002). “Histological grading of papillary urothelial carcinoma of the bladder: prognostic value of the 1998 WHO/ISUP classification system and comparison with conventional grading systems”. J Clin Pathol. 55 (12): 900–5. PMC 1769816. PMID 12461053.

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