Transitional cell carcinoma classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Based on the growth pattern, transitional cell carcinomas may be classified into either papillary urothelial carcinoma or non-papillary urothelial carcinoma.

Classification

Based on the growth pattern, transitional cell tumors may be classified into two subtypes:

Type	Description
Papillary urothelial carcinoma	Slim finger-like projections that grow from the lining of the renal pelvis or ureter into the cavity
Non-papillary urothelial carcinoma	Sessile or nodular tumors They grow deeper into the layers of the wall of the renal pelvis or ureter rather than into its cavity

WHO Classification

The World Health Organization in a collaborative effort conjointly with the International Society of Urological Pathologists (ISUP) published a consensus opinion classification system for urothelial (transitional cell) tumors:

Transitional cell tumors

Infiltrating urothelial carcinoma with squamous differentiation with glandular differentiation with trophoblastic differentiation Nested Microcystic Micropapillary Lymphoepithelioma-like Lymphoma-like Plasmacytoid Sarcomatoid Giant cell Undifferentiated

Non-invasive urothelial carcinoma Urothelial carcinoma in situ High grade papillary urothelial carcinoma Low grade papillary urothelial carcinoma Non-invasive papillary urothelial neoplasm of low malignant potential Urothelial papilloma Inverted urothelial papilloma

Grading

According to the WHO grading criteria, there are two grades of transitional cell carcinoma based on the degree of cellular differentiation:

Grade	Description
Low grade	Tumors with the least degree of cellular anaplasia Rarely invades the muscular wall of the bladder or spreads to other parts of the body Often recurs in the after treatment
High grade	Tumors with the most severe degrees of cellular anaplasia Commonly recurs and also has a strong tendency to invade the muscular wall of the bladder and spread to other parts of the body. High grade transitional cell carcinoma is much more likely to result in death