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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Transitional cell carcinoma classification

Introduction

Overview

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

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

References

  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.
  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.

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]