Diagnostic difficulties in cases of papillary urothelial neoplasm of low malignant potential, urothelial proliferation of uncertain malignant potential, urothelial dysplasia and urothelial papilloma: A review of current literature

Jaworski, Damian; Szylberg, Łukasz; Gzil, Arkadiusz; Stawinski, Peter; Kasperska, Anna; Marszałek, Andrzej

doi:10.1016/j.anndiagpath.2017.12.007

Cited by 8 publications

(7 citation statements)

References 47 publications

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“…Macroscopic hematuria, flank pain and palpable flank mass are three main clinical presentation of RCC but such typical tumors are rare at present due to increasing use of imaging (4). Microscopic or macroscopic hematuria is the most common symptom of UC and symptomatic hydronephrosis occurs if the tumor locates at the ureteropelvic junction (5). Both RCC and UC are more common in men vs. women.…”

Section: Introductionmentioning

confidence: 99%

Intrarenal urothelial cancers confused as infiltrative renal masses: Report of 22�cases and literature review

Ding

Jia

et al. 2018

Oncol Lett

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Distinguishing infiltrative renal masses (IRMs) from intrarenal urothelial cancers (IUCs) is critically important, but may be challenging for any radiologist or urologist. The present study aimed to summarize the clinical, imaging and pathological characteristics of IRM, which were postoperatively confirmed as IUC. The analysis was performed using the records of 22 patients who were preoperatively diagnosed with IRM but the results of percutaneous biopsies or postoperative pathological analyses led to diagnoses of urothelial cancers (UCs) from January 2011 to December 2017. The demographic data, computed tomography (CT) imaging features and pathological characteristics were evaluated. The present study also reviewed the literature concerning the IRM and IUC. The mean age of patients was 62 years and 86.4% of them were >55 years. The sex and tumor side distributions were equal. Hematuria and/or flank pain were observed in 86.4% of patients. All patients exhibited endophytic solid renal masses with unclear tumor boundaries on CT images. The kidneys of 81.8% of patients maintained their normal shape while mild alternations were observed in 18.2% of cases. A total of 81.8% of patients maintained the reniform shape and 18.2% exhibited mild contour change. Of all patients, all tumors exhibited less or equal attenuation on unenhanced CT images and they were mildlyimproved on enhanced CT. A total of 6 cases were confirmed by biopsy, when patients underwent laparoscopic nephroureterectomy instead of radical nephrectomy. The remaining 16 patients underwent laparoscopic nephrectomy but the postoperative pathological diagnoses revealed the presence of UCs. All postoperatively confirmed cancers were stages T3 and T4 (62.5 and 37.5%, respectively). UCs should be suspected in middle aged or elderly middle-elderly patients presenting renal masses with endophytic solid unclear tumor boundary on unenhanced and slightly enhanced CT images, accompanied with hematuria and/or flank pain. Preoperative biopsy is preferred for complicated cases.

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Section: Introductionmentioning

confidence: 99%

Intrarenal urothelial cancers confused as infiltrative renal masses: Report of 22�cases and literature review

Ding

Jia

et al. 2018

Oncol Lett

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“…10 These lesions frequently recur and infrequently progress to low-grade papillary urothelial carcinoma (LGPUC) or HGUC, although stage progression is rare. 17 …”

Section: Questions/discussion Pointsmentioning

confidence: 99%

“…10 These lesions frequently recur and infrequently progress to low-grade papillary urothelial carcinoma (LGPUC) or HGUC, although stage progression is rare. 17 Low-Grade Papillary Urothelial Carcinoma. On histology, LGPUC shows fused and branching papilla with minimal loss of polarity.…”

Section: Discuss the Classification Of Noninvasive Papillary Urothelimentioning

confidence: 99%

Educational Case: Urothelial Carcinoma: An Overview of Pathologic Diagnosis

et al. 2020

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The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see http://journals.sagepub.com/doi/10.1177/2374289517715040 .1

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“…Such techniques are not currently employed in routine clinical practice. Some investigators have attempted to discriminate recurrent from non‐recurrent PUNLMPs using immunohistochemistry for a variety of markers, including FGFR3, cytokeratin 20, Ki‐67, claudin‐1 and Aurora‐A 50 . Future studies will be required to validate the utility of these markers.…”

Section: Risk Stratification Based On Tumour Biomarkers and Molecularmentioning

confidence: 99%

Reappraisal of the papillary urothelial neoplasm of low malignant potential (PUNLMP)

Jones¹,

Cheng

2020

Histopathology

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Although the papillary urothelial neoplasm of low malignant potential (PUNLMP) diagnostic category was retained in the updated 2016 World Health Organisation (WHO) classification of tumours of the urinary system, there still exists a great deal of controversy regarding the biological behaviour of these tumours. We review PUNLMP tumours and histological grading with an emphasis on the histomorphological, genetic and clinical similarities between PUNLMP and low-grade non-invasive papillary urothelial carcinoma. A literature search using PubMed was performed. All relevant literature concerning PUNLMP and the grading of urothelial tumours was reviewed. PUNLMPs cannot be reliably distinguished from low-grade non-invasive papillary urothelial carcinomas based on the histomorphological criteria outlined in the WHO 2004/2016 classification system. PUNLMPs and lowgrade non-invasive papillary urothelial carcinomas are not only morphologically similar, but also share similar molecular genetic alterations and a similar risk of recurrence and progression. In addition, there are no consensus recommendations for a different method of treatment and follow-up for these two tumour types. Attempting to distinguish PUNLMP from low-grade papillary urothelial carcinoma adds an unnecessary level of complexity to the grading and classification of urothelial tumours. We feel that PUNLMP terminology should be abandoned and that all such tumours should be classified as low-grade carcinomas until more objective determinants of clinical outcome can be established.

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Diagnostic difficulties in cases of papillary urothelial neoplasm of low malignant potential, urothelial proliferation of uncertain malignant potential, urothelial dysplasia and urothelial papilloma: A review of current literature

Cited by 8 publications

References 47 publications

Intrarenal urothelial cancers confused as infiltrative renal masses: Report of 22�cases and literature review

Intrarenal urothelial cancers confused as infiltrative renal masses: Report of 22�cases and literature review

Educational Case: Urothelial Carcinoma: An Overview of Pathologic Diagnosis

Reappraisal of the papillary urothelial neoplasm of low malignant potential (PUNLMP)

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