HISTOPATHOLOGICAL DIAGNOSIS OF BLADDER UROTHELIAL CARCINOMA ON TRANSURETHRAL RESECTION SPECIMENS

The presentation "Histopathological Diagnosis of Bladder Urothelial Carcinoma on Transurethral Resection Specimens" evaluates urothelial carcinoma (UC) diagnosed via transurethral resection of bladder tumor (TUR-V) at the Emergency County Hospital Târgu Mureș over a five-year period. The study analyzes tumor classification (papillary, infiltrative, carcinoma in situ), TNM staging, and variant histopathological subtypes. It emphasizes the critical role of TUR-V in the diagnosis, staging, and therapeutic planning of bladder cancer, guiding subsequent treatment options.

1. HISTOPATHOLOGICAL DIAGNOSIS OF BLADDER UROTHELIAL CARCINOMA ON TRANSURETHRAL RESECTION SPECIMENS Author: Cosma Catalin-Dumitru III rd year student, General Medicine Coordinators: Professor Angela Borda Associate professor Andrada Loghin Coauthors: Muresan David Victor Vacariu Catalin Daniel Badaluta

2. Background Bladder cancer comprises a large spectrum of tumors s ome behave in a relatively benign fashion , others are highly aggressive and lead rapidly to metastatic disease and death urothelial carcinomas (UCs), most frequent tumor type other types : squamous cell carcinoma , adenocarcinoma , ect

3. Background Endoscopic treatment with transurethral resection of bladder tumor (TUR-V) - the first-line treatment to diagnose , stage , and treat visible tumors .

4. Aims to evaluate the UCs diagnosed on the transurethral resection (TUR-V) specimens in the Department of Pathology , Tîrgu-Mureş Emergency County Hospital, over a 5 year period .

5. Materials and methods We included in our study : all the patients with a TUR-V performed in the Department of Urology and examined in the Department of Pathology , Tirgu Mures Emergency County Hospital between January 2010 and December 2014 Clinicopathological data : a ge gender histopathological diagnosis (UC, common type, variants)

6. CIS - Cancer cells are found only in the epithelium pTa - tumor has grown into the lamina propria or the muscle layer   pT1 - Tumor invades lamina propria or muscular layer pT2 - Tumor invades perimuscular connective tissue   pT3 - Tumor perforates the serosa pT4 - The tumor has grown into one of the main blood vessels leading into the liver   pTx - Primary tumor cannot be assessed pT0 - No evidence of primary tumor TNM Classification of Malignant Tumours 7th Edition, 2009

7. Material and methods Common type Tumoral cells appear arranged in lobules. Desmoplastic stroma. Most are pT2 – pT4 Neoplastic cells : Medium size Small amount of eosinophilic cytoplasm Hyperchromatic nuclei UC histopathological diagnosis Variants

8. Material and methods Papillary UC

9. Results 1454 TUR-V cases examined in the Department of Pathology between January 2010 and December 2014 male predominance (81 %) average age: 67 years-old, ranging from 18 to 90

10. Results A diagnosis of UC was established in 75.3% cases only papillary UC (38%), papillary and infiltrative UC (28%) only infiltrative UC (25,5%) CIS carcinoma (8,5%) other rare bladder tumors represented 3.1 % of cases benign lesions , the most common cystitis, were found in 21.6 % cases

11. Results TNM stage Papillary UC pTa 100%     CIS pTa 100%     Infiltrative UC pT1a 16,8% pTx 10,5%   pT1 24,5%       pT2 38,2%     Infiltrative and papillary UC pT1a 13,6% pTx 14,4% pT1 15,4%       pT1 at least 30,5%       pT2 26,1%    

12. Results Other rare bladder tumors (3.1%) Adenocarcinoma Neuro -endocrine carcinoma Epidermoid carcinoma Small cell carcinoma Sarcomatoid carcinoma

13. Results Benign lesions 21.6 % cases the most common cystitis

14. Conclusion Histopahological diagnosis on TUR-V specimens can establish a correct and complete diagnosis of UC (including the histologic variant and the pathological stage), in order to allow subsequent therapeutic options.