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Pathology for Urologists

Papillary Urothelial Carcinoma, High Grade


Image A
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Image B
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  • Papillary urothelial neoplasm with moderate to high-grade cytology.
  • Includes some former 1973 WHO TCC grade 2 and all grade 3.
  • Histology:
    • 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%.

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