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Pathology for Urologists

Urothelial Dysplasia


Image A
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Image B
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  • Atypical cytologic and architectural features felt to be neoplastic that fall below the threshold for CIS.
  • Suffers from poor diagnostic reproducibility.
  • Histology:
    • Nuclear abnormalities in the absence of inflammation, or disproportionate in the presence of inflammation, but not severe enough to merit CIS (image A) & (image B).
    • Usually normal urothelial thickness.
    • Mild loss of polarity and nuclear crowding.
  • Immunohistochemistry: may aberrantly express CK20 and have higher p53+.
  • On follow-up, 5-19% progress to bladder neoplasia including CIS.

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