1. BLADDER Dr Frances McCormick Derriford Hospital

3. Anatomy

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

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

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

13. Name and Classificiation

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

15. Flat Lesions Inflammatory Dysplastic CIS ? denuded

22. Is it CIS?

27. Does Immuno help? Cytokeratin 20 CD44/cyt5 MIB1 p53

28. Is it papillary? Inflammatory Metaplastic Neoplastic

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

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

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

70. The END Any questions?