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Bladder Cancer Biopsy

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Bladder Cancer Biopsy

Postby Trevelian » Sun Jun 01, 2014 4:11 am

My father: 69 years old.  History: Hematuria started 1 year ago with no follow-up(stopped by itself - thought it was a UTI).  Transurethral Resection of the Tumor was performed 1 1/2 week ago. Father feels great. Here are the biopsy results:

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1 gram of soft grayish tissue

PIT/1 block

Microscope:

Specimen included fragments from papillary urothelial tumor.  The latter is endo and exophytic characterized by either slender of large coalescent papillae, lined by neoplastic urothelium, exhibiting mild to moderate anisonucleosis with increase of nuclear cytoplasmic ratio.

The polarity is either well preserved or slightly disturbed at the lower layers.

Mitoses are observed with the deep layers.  Three is no infiltration of the lamina propria and the muscularis propria is not represented.

Diagnosis:

Papillary urothelial carcinoma of low grade of malignancy.  Grade: G2(WHO/ISUP98)(WHO73).  

Non infiltrating stage.

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What does all this mean?  The urologist said to not worry about it - it looks good(?)  My father will undergo CT scan next week to be safe(?) as the dr. says.  I don't get it - my father was told its benign but I am reading black on white "Low grade of malignancy" so it is a beginning of cancer isn't it?  How can they be sure they got everything out of his bladder... he is not doing any treatment right now following the surgery - how can we be sure a leftover cell doesnt wander around & develops into something more invasive? What is your opinion on the biopsy results & what would you recommend doing next?(and then what?...)  

Thank you so much for taking the time to read this.  My father lives overseas & I am very concerned(not being able to sit by him & ask the doctor all these questions...
Trevelian
 
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Joined: Wed Jan 22, 2014 11:15 am

Bladder Cancer Biopsy

Postby Durwin » Sun Jun 01, 2014 12:00 pm

Hello Nina:

Papillary urothelial carcinoma of low grade malignancy, is definitely cancer. However, it is the type which rarely spreads to other sites. If completely resected this has an excellent prognosis(10 year survival 95% or more)

There are no features suggesting higher grade(like pleomorphism etc)

If any symptoms recur check up has to be done by the physician to rule out recurrence. A third of the cases recur in which a minority can be high grade. For this reason a follow up CT scan is advised(frequency will be decided by the oncologist)

The imaging studies can only reveal visible left over lesion, however if there are any cells left at microscopic level there is no way of confirming these.... may lead to recurrence, hence follow up is advised.
Durwin
 
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Joined: Wed Jan 01, 2014 5:28 am


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