BLADDER Dr Frances McCormick Derriford Hospital.

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Presentation transcript:

BLADDER Dr Frances McCormick Derriford Hospital

Anatomy

Specimens Cytology Biopsy, TURBT Cystectomy, partial or radical Anterior exenteration

Handling1 Cytology – 2 pap slides. Biopsies – all embedded, 3 levels. TURBT – depends on quantity of chippings (Fractionated resection).

Handling2 Partial cystectomy Radical cystectomy - female, female adnexae and ant vagina - male, prostate and seminal vesicles Anterior exenteration - +AP resection

Name and Classificiation

Is it neoplastic? If it is a flat lesion? If it is a papillary lesion?

Flat Lesions Inflammatory Dysplastic CIS ? denuded

Is it CIS?

Does Immuno help? Cytokeratin 20 CD44/cyt5 MIB1 p53

Is it papillary? Inflammatory Metaplastic Neoplastic

Is it Invasive? Scarring Involvement of Von Brunn’s nests Inverted growth pattern

What is the stage? Diathermy artefact – stage pTx Muscularis mucosae Vs Muscularis propria Fat invasion Muscularis propria invasion Invasion into the prostate

Urothelial Ca/TCC Grading Differentiation A few interesting subtypes, micropapillary, nested Immunohistochemistry, cyt 7, cyt 20, Gata3, 34BE12

The END Any questions?