Urothelial neoplasms: a review of pathological reporting practices

Urothelial carcinoma has observed great strides of advances in the field of diagnostics and therapeutics. On the other hand, the last decade witnessed an upheaval in pathological grading which seems to settle down in the recent times.

Our study intends to evaluate pathology practices in reporting papillary urothelial carcinomas and highlight the features which can define prognosis and guide molecular studies.

A consecutive of 32 cases of papillary urothelial carcinoma reported over duration of 2 years were collected. Histopathological slides were reviewed applying WHO/ISUP 2004 diagnostic criteria and compared with primary diagnosis.

High grade papillary urothelial carcinoma formed the largest group with 14 cases. Concordance between original diagnosis and review diagnosis was seen in 19 cases only. Invasion into underlying tissue was missed in 6 cases. Associated features like carcinoma in situ, lymphovascular invasion, perineural invasion and stalk invasion were missed in primary reports.

As grade and stage dictate prognosis and management plans, it is essential to release veritable reports. The findings emphasize the need to generate a consensus report with multiple opinions.