Department of Pathology and Surgery, Faculty of Medicine, Cordoba, Spain.
Pathology Service, Champalimaud Clinical Center, Lisbon, Portugal.
Histopathology. 2019 Jan;74(1):77-96. doi: 10.1111/his.13752.
Pathological evaluation of bladder cancer typically reveals great tumour heterogeneity, and therefore the common observation of urothelial carcinoma exhibiting a wide variety of histopathological patterns is not surprising. Some of these patterns are so distinctive that they have been recognised as specific variants of urothelial carcinoma. Classifications have recently been revised in the 2016 World Health Organisation (WHO) classification of tumours of the urinary system and male genital organs. The current WHO classifications clarify terminological issues and provide better definition criteria, but also incorporate some new entities. Many of these variants have important prognostic or therapeutic implications worth knowing by the urologist and oncologist, but also represent diagnostic challenges in daily pathology practice. This review will discuss the features of variants of urothelial carcinoma in the context of our current clinical practice. Histological variations and new entities of bladder cancer not included in the current WHO classification of urothelial tumours will be briefly discussed.
膀胱癌的病理评估通常显示出很大的肿瘤异质性,因此观察到尿路上皮癌表现出多种组织病理学模式并不奇怪。其中一些模式非常独特,已被认为是尿路上皮癌的特定变体。在最近的 2016 年世界卫生组织(WHO)泌尿系统和男性生殖器官肿瘤分类中,已经对分类进行了修订。目前的 WHO 分类澄清了术语问题,并提供了更好的定义标准,但也纳入了一些新实体。这些变体中的许多具有重要的预后或治疗意义,值得泌尿科医生和肿瘤学家了解,但在日常病理实践中也代表了诊断挑战。这篇综述将结合我们目前的临床实践讨论尿路上皮癌变体的特征。本文将简要讨论目前未纳入尿路上皮肿瘤 WHO 分类的膀胱癌的组织学变异和新实体。