American Urological Association - Papillary Urothelial Carcinoma, High Grade
Papillary Urothelial Carcinoma, High Grade
- Papillary urothelial neoplasm with moderate to high-grade cytology.
- Includes some former 1973 WHO TCC grade 2 and all grade 3.
- Papillae more complex with fusion or confluence.
- Loss of cellular polarity, often crowded and overlapping.
- Moderate to marked pleomorphism, prominent nucleoli and abundant mitosis, at any level
(image A) & (image B).
- In cases of tumors with mixed low-grade and high-grade (should be at least 5%) areas, the overall grade is assigned as high-grade.
- Presence of invasion should always be thoroughly excluded.
- Recurrence rate of 34-74% and progression rate to invasive cancer of 15-40%.