Urothelial Carcinoma In Situ (CIS): New Insights

Abstract

Urothelial carcinoma in situ (CIS) is a high-grade noninvasive malignancy with a high tendency of progression. Although it is typically grouped with other nonmuscle invasive bladder cancers, its higher grade and aggressiveness make it a unique clinical entity. Urothelial CIS is histologically characterized by replacement of the urothelium by cells which fulfill the morphologic criteria of malignancy including nuclear pleomorphism, hyperchromasia, prominent nucleoli, and increased numbers of normal and abnormal mitoses. Urothelial CIS may be categorized as primary when it is not associated with any past or present urothelial carcinoma. It is termed as secondary when there is concomitant or previous urothelial carcinoma in the patient. In recent years detailed molecular studies have provided valuable data for intrinsic molecular subclassification of urothelial carcinoma into 2 broad categories namely luminal and basal types with significant implications for prognosis and therapy. Similar studies on urothelial CIS are limited but have provided crucial insight into the molecular basis of CIS. These studies have revealed that urothelial CIS may also be divided into luminal and basal subtypes, but luminal subtype is much more common. It has also been shown that in many cases, luminal type of urothelial CIS may undergo a class switch to basal type during progression to an invasive carcinoma. Additional studies may be required to confirm and further elaborate these findings.

Ocurrence enzootic hematuria in buffaloes in Brazil: epidemiological, clinical, and pathological aspects

“…All classification systems are hampered by varying subjectivity that affects interobserver reproducibility (Cheng et al 2012). In considering the classification of human dysplasias, the World Health Organization (WHO) recommends, since 2004, not to grade them owing to the lack of criteria to distinguish dysplasias from mild-to-moderate and highgrade carcinomas in situ (Hodges et al 2010, Akhtar et al 2019. However, in this work, the nomenclature standards used for cattle with EH were followed (França 2002, Peixoto et al 2003.…”

Canadian Urological Association guideline on the management of non-muscle invasive bladder cancer

“…CIS is rarely found in isolation, with the majority of cases (90%) being found in association with papillary or nodular bladder tumours 87,100 . CIS can be classified as primary (no previous history of bladder cancer), which carries the best prognosis, concomitant (with a papillary or nodular tumour) or secondary (new lesion diagnosed during followup) 101,102 . CIS is also considered a field disease, as it can affect multiple areas in the bladder, the upper urinary tract, and the urethra 103 .…”

Bladder Cancer Sample Handling and Reporting: Pathologist's Point of View

“…It is very often multifocal and isolated ~3% of cases. It is present with a synchronous non-muscle invasive urothelial carcinoma or with muscle invasive carcinoma in 50 and 60%, respectively ( 21 , 56 ).…”