Epithelial lining is identical to normal urothelium but increased in thickness. No lamina propria A total of 120 papillary urothelial pTa and pT1 tumors (8 papillomas, 8 neoplasms of low malignant potential, and 42 low-grade and 62 high-grade carcinomas) were immunostained by using CK20 and CD44 antibodies. Understanding Your Pathology Report: Breast Cancer hot www.cancer.org. Invasive into lamina propria. The tumour starts from cells that normally line the inside of the bladder, ureters, or urethra. For carcinoma component, acinar adenocarcinoma is the most common pattern. In many instances, the presence of papillary morphology is reassuring of the urothelial histogenesis of a high-grade invasive lesion but is not pathognomonic. Mutations in this gene are associated with a variety of … Papillary urothelial carcinoma is a type of bladder cancer that forms in the inner lining of the bladder, ureters, or lower kidneys. The bladder is a muscular organ in the pelvis that stores urine until it can be excreted. Bladder cancer happens when abnormal cells in the bladder grow too quickly. I am seeking input from those who have received a cytology of Atypical Urothelial Cells in the last 2 years, since the Paris System. papillary fronds with minimal branching or fusion, cytology and thickness of normal urothelium, no mitoses. papillary urothelial carcinoma and 16 were high grade non-invasive papillary urothelial carcinoma. The histological criteria for diagnosis are strict. Pich A, Chiusa L, Formiconi A, et al. Lopez-Beltran et al. Overall papillary carcinoma carries a relatively good prognosis with a 20 year survival rate of ~90%. The 5 year survival is in the range of 95%. Invasive into lamina propria. Chromophobe shows multiple losses of whole chromosomes, most often 1, 2, 6, 10, 13, 17, 21 or Y but documentation of monosomies is not required for diagnosis. Dysplasia (low grade intra-urothelial neoplasm) Significant atypia but falling short of CIS Nuclear membrane irregularities; Dense, clumped chromatin; Nuclei may be 2x size of lymphocytes but few reach 5x size of lymphocytes; Loss of polarity; Lack of significant inflammation; Frequently seen adjacent to carcinoma 113,119,120 Code grade 9 for urothelial carcinoma in situ . Bladder Cancer, 2, Soloway M, Khoury S (Eds), 2nd International Consultation on Bladder Cancer, Vienna 2012. non papillary: usually T2+ tumors, high grade. papillary urothelial neoplasm of low malignant potential (PUNLMP) means it is a very slow growing tumour that is unlikely to spread. low grade (occasional mitosis) high grade features. Thus, low-grade urothelial carcinoma manifests CK expression limited to the umbrella cells, while high-grade tumors usually have an expression in the entire thickness of the urothelium except for the basal layer. The 2004 World Health Organization classification system for urothelial neoplasia identifies urothelial dysplasia (low-grade intraurothelial neoplasia) as a premalignant lesion of the urothelium. Christopher D.M. I had 5 tumors removed over the course of two years, and no tumors have been found 2.5 years since then. 2.4. Urothelial papilloma. Complex solid to fused papillary architecture, nuclear atypia, pleomorphism (may be focal), crowded and overlapping cells, brisk mitotic activity. The grading of papillary urothelial carcinoma is based on the worst grade present. No mitotic figures. Pathology confirmed urothelial carcinoma. Papilloma Low grade papillary urothelial neoplasm High grade papillary urothelial neoplasm WHO (1973) WHO (2004) Grade 1 PUNLMP Low-grade Grade 2 Grade 3 High-grade Papilloma Papilloma WHO/ISUP 2004 Provided detailed criteria for each category The most common type of bladder tumour in the Western world is a non-invasive, papillary tumour, which accounts for approximately 45% of all primary bladder tumours. ... carcinoma or high-grade papillary urothelial carcinoma. High-grade urothelial carcinoma is a type of bladder cancer that has a high risk of becoming aggressive and progressing, as stated by the John Hopkins University Department of Pathology. 2009). Low-grade papillary urothelial carcinomas are characterized by orderly appearance of cells that are evenly spaced and cohesive. Jump to navigation Jump to search. Anastomosing cords and columns of urothelium resembling inverted papilloma or broad pushing bulbous invaginations into lamina propria (broad front pattern) The trabecuale are wider and more irregular than those of inverted papilloma. In 1998, World Health Organization, International Society of Urological Pathology and Canadian Academy of Pathology purposed classification of urothelial tumors called WHO/ISUP Consenses Classification and classified urothelial papillary tumors into papilloma, papillary urothelial neoplasm of low malignant potential (PUNLMP), low grade carcinoma (LGC) and high … With guidance from the CAP Cancer and CAP Pathology Electronic Reporting Committees. Papillary urothelial carcinoma, low grade Papillary urothelial carcinoma, high grade Papillary urothelial neoplasm of low malignant potential Urothelial papilloma ... Reclassification after pathology re-review - radical cystectomy (n=1,211) Mayo Clinic experience (Linder et al. In a needle biopsy, a needle is used to remove a sample of an abnormal area. Minor changes: 30 March 2020 ↑ 5.0 5.1 5.2 Maxwell, Jay P; Wang, Cheng; Wiebe, Nicholas; Yilmaz, Asli; Trpkov, Kiril (2015). … 2, 3 Several systems have been proposed to grade urothelial … The 1998 WHO/ISUP system also introduced specific descriptions and histologic criteria to define the various grades and categories. urothelial theconcept of low-grade and high-grade tumours, aswell papillary 2016 neoplasm of low malignant potential category which is retained in the shown classification. Although technically in situ, non-invasive papillary urothelial neoplasms are staged as … Nested variant of urothelial carcinoma (NVUC) is a rare variant of urothelial carcinoma with a deceptively bland appearance and a reported incidence of 0.3% of invasive bladder tumors . LM. High grade papillary urothelial carcinoma. We reported herein four cases of carcinomas in the bladder with papillary morphology that had a final diagnosis different from … 7, 12 Two different. Histological grading for invasive bladder carcinoma is of limited utility, as the majority of these tumors are high-grade or grade 3 urothelial carcinoma. Papillary Urothelial Carcinoma, High Grade. Information regarding multiplicity was obtained from surgery notes and pathology reports. Urothelial carcinoma shows wide plasticity and broad morphologic spectrum. There are two types of papillary renal cell carcinoma. This gene encodes a member of the family of estrogen receptors and superfamily of nuclear receptor transcription factors. Urothelial carcinoma in situ (CIS) of the bladder with glandular differentiation (CIS-GL) is rare with some showing an association with small cell carcinoma. Treatments given to relieve pain and symptoms rather than to cure the disease. Urothelial bladder carcinoma is an attractive model for biomarker discovery and translational research. Most clinical cases of urothelial neoplasm present with a papillary growth one, which accounts for about 85% of urothelial neoplasms (1), while fewer cases present with flat or inverted growth patterns. Topic Completed: 1 December 2014. Out of total 121 cases, 33 (27.3%) cases were those of invasive urothelial carcinoma, while 88 Fig. However, low sensitivity of the method reflects the unreliable cytopathologic diagnosis of … Urothelial carcinoma characterized by cells with an appearance similar to plasma cells and a pattern of single cell infiltration. Microscopic. Papillary Urothelial Carcinoma, Low-Grade ; Papillary serous cystadenocarcinomas are the most common form of malignant ovarian cancer making up 26 percent of ovarian tumours in women aged over 20 in the United States.. Upon binding to 17beta-estradiol or related ligands, the encoded protein forms homo- or hetero … low grade papillary urothelial carcinoma, PUNLMP. Am J Surg Pathol 2001; 25:1528. Cases were classified according to the 2004 WHO/ISUP systems as 212 cases of papillary urothelial neoplasm of low malignant potential (PUNLMP), 706 low-grade papillary urothelial carcinomas (LPUCs), and 597 high-grade papillary urothelial carcinomas (HPUCs). All cases were those of papillary urothe-lial carcinoma. papillary renal cell carcinoma pathology outlines. I have a history of noninvasive low-grade papillary urothelial carcinoma. Papillary renal cell carcinoma, or PRCC, is a type of kidney cancer. Non–muscle-invasive bladder cancer (NMIBC) is the predominant phenotype, affecting about 70% of patients, and is typically characterized by frequent tumor recurrence after the initial transurethral resection of the bladder tumor, followed, in cases … Prior to the diagnosis of papillary urothelial hyperplasia, 30 patients had a history of 43 prior neoplasms, 79% of … By 1973 criteria, grade 2 tumors were a heterogeneous group; with 1998 criteria, nearly one-half were high grade and the other half low grade. CAP Approved UreterRenalPelvis_2.2.0.0.REL_CAPCP 2 . Bladder: Carcinoma •Urothelial carcinoma!!! grade morphology, whereas 47.9% (58 cases) showed low grade histology. Prevalence. Plasmacytoid urothelial carcinoma is a rare variant of urothelial neoplasm described in the urinary bladder in association with high-grade tumors. Site. neuroendocrine tumors, pituitary tumor, schwannoma, meningioma, sarcoma, etc.) Immunohistochemistry not required for diagnosis. J Urol 2013) (33% of entire cohort ) voke the differential diagnosis with high-grade papillary urothelial carcinoma. When cystoscopic lesions measured ≥2 cm rather than <2 cm, initial urine cytology tended to be positive or suspicious for UC (5 of 21 lesions [23.8%] vs 1 of 26 lesions [3.8%], respectively; P = .076). The pathology report says that I have Stage T1, with two types of cancer present: • High-grade papillary urothelial carcinoma in right lateral wall. Oncocytoma is a benign renal tumor. Papillary urothelial carcinoma is a type of bladder cancer. Approximately 10 months later, a 1.3 × 1.1 cm nodule in the upper lobe of her left lung was seen on CT scan. Urothelial carcinoma characterized by cells with an appearance similar to plasma cells and a pattern of single cell infiltration. papillary: usually T1 tumors. H&E stain. Muscularis propria negative for tumor. Pathology. An unusual finding was the presence of invasive low-grade urothelial carcinoma associated with myxoid stroma in 5 cases, 4 of which had an overlying low-grade papillary urothelial carcinoma component. p16 is a tumor suppressor gene; therefore loss of its function results in abnormal cell proliferation … • Flat urothelial carcinoma in situ, in bladder neck and posterior wall. Frond-like appearance. Papillary renal cell carcinoma is a cancer of the tubes that filter those waste products from the blood. Although diagnostic criteria of urothelial dysplasia have been improved in recent years, there is a frequent lack of interobserver reproducibility. ... ___ Noninvasive low-grade papillary urothelial carcinoma present at margin . [] reported that sarcomatoid urothelial carcinoma usually presents between the ages of 50 years and 77 years and the mean age of presentation is 66 years.Black et al. Thus, low-grade urothelial carcinoma manifests CK expression limited to the umbrella cells, while high-grade tumors usually have an expression in the entire thickness of the urothelium except for the basal layer. Urothelial carcinoma is the most common morphologic type of bladder cancer. Low grade papillary urothelial carcinoma has zonula occludens (tight junctions) and well developed macula adherens (desmosomes), with fewer surface vesicles than normal epithelium Molecular / cytogenetics description Carcinoma component typically PSA+ or PSAP+. Villous adenomas of the bladder usually coexist with in Treatments given to relieve pain and symptoms rather than to cure the disease. The gene product contains an N-terminal DNA binding domain and C-terminal ligand binding domain and is localized to the nucleus, cytoplasm, and mitochondria. Any of the following are evidence of invasion and exclude the diagnosis of inverted pattern It starts in urothelial cells in the bladder lining. ~25: low-grade papillary urothelial carcinoma. Noninvasive papillary urothelial neoplasm with moderate to marked cytoarchitectural abnormality. Atypia absent to minimal. While the majority of urothelial cancers (approximately 90-95%) arise in the bladder, upper tract urothelial cancers (UTUCs) correspond to a subset of urothelial cancers that arise in the lining of the kidney (called the renal pelvis) or the ureter (the long, thin tube that connects that kidney to the bladder). Biologic differences between noninvasive papillary urothelial neoplasms of low malignant potential and low-grade (grade 1) papillary carcinomas of the bladder. In urothelial carcinoma, FGFR3 alterations have been docu-mented in nearly 60% of low-grade noninvasive papillary urothelial carcinoma of the bladder [11] and 26.7% of overall urothelial carcinoma [12]. Pathology Outlines. CIS is aggressive and tends to progress to muscleinvasive cancer. urothelium - typically urinary bladder. Gross. Papillary urothelial hyperplasia. Furthermore, while molecular markers are available that have been tocontribute a more accurate histological grading of urothelial carcinomas, * Corresponding author. Urothelial carcinoma in situ . pTa low-grade 56 62 pTa high-grade 20 9 pT1 low-grade 4 1 pT1 high-grade 12 23 pT2 high-grade 8 7 pT3 high-grade 8 0 pT4 high-grade 1 0 Not available 2 0 Stage/grade distribution II, No. A malignant neoplasm with small cell neuroendocrine carcinoma component arising in … PUNLMP vs. low grade papillary urothelial carcinomahas a poor inter-rater reliability. Most are solitary, and show a similar cystoscopic appearance to low grade papillary urothelial carcinoma. Three-Grade System (Nuclear Grade) There are several sites for which a threegrade system is used. ... Papillary Urothelial Carcinoma, Low-Grade. LM DDx. Inverted/ Urothelial papilloma & PUNLMP & pTa low-grade 63 (54.3) 73 (64.6) p=0.08 High-grade papillary urothelial carcinoma - Libre Pathology The incidence in upper tract high-grade urothelial cancer is 35.6% [13]. Code grade 3 (poorly differentiated) for non-invasive papillary urothelial (transitional) carcinoma, high grade . Classical invasion across the urinary bladder wall and/or to surrounding tissues was found in 17 cases of low-differentiated HG UCs. In the majority of cases an associated invasive carcinoma is present, with colloid and neuroendocrine carcinomas being the most common. Hello. The encoded protein responds to diverse cellular stresses to regulate expression of target genes, thereby inducing cell cycle arrest, apoptosis, senescence, DNA repair, or changes in metabolism. Four patients in the de novo category developed subsequent bladder neoplasia (4 of 26; 15.4%) and included 3 patients with low-grade papillary urothelial carcinoma and 1 patient with invasive high-grade urothelial carcinoma. Incidence. Papillary urothelial neoplasm of low malignant potential (PUNLUMP) Occasional branching of fibrovascular cores. These lesions can manifest as papillary (exophytic) as well as flat and inverted (endophytic) growth patterns. Abbreviations: AU, atypical urothelial cells; HGUC, high-grade urothelial carcinoma; LGUC, low-grade urothelial carcinoma. This gene encodes a tumor suppressor protein containing transcriptional activation, DNA binding, and oligomerization domains. G1 carcinoma consists of a urothelium more than seven cell layers thick containing cells that display minimal to slight nuclear enlargement, normal or slightly distorted architecture, and rare or … An unusual finding was the presence of invasive low-grade urothelial carcinoma associated with myxoid stroma in 5 cases, 4 of which had an overlying … The two main types of urothelial carcinoma (UC) are papillary UC (pTa) and flat UC (pTis), also known as noninvasive carcinoma in situ. Pathology Outlines - Chromophob. Micropapillary urothelial carcinoma is a rare aggressive subtype of transitional cell carcinoma. Key characteristics: Nuclear - size/pleomorphism. Most papillary urothelial carcinomas start in the bladder. High-grade papillary urothelial carcinoma. in differentiating urothelial carcinoma from prostate adenocarcinoma and squamous cell carcinomas of the uterine cervix, anus and lung Chang A et al Am J Surg Pathol 2012;36:1472-6. PRCC makes up about 15% of all renal cell carcinoma, which is the most common type of kidney … 2006 Jun;37 (6):698-703. [2, 3] It is unclear whether squamous papilloma represents the squamous counterpart of urothelial papilloma.Although there is no … Diagnosis: invasive low grade papillary urothelial carcinoma Week 380: Case 5 Diagnosis: herpes infection high grade papillary urothelial carcinoma Week 349: Case 5 ... We’d like to send you periodic updates regarding Pathology educational materials released by our department. Pathologically, solid papillary carcinomas exhibit low-grade features, and often the tumors display neuroendocrine and mucinous differentiation. The tumour grade was assessed according to the 2004 WHO classification of tumours of the urinary system (20). architecture distortion. Papillary tumors tend to recur but not progress to invasive cancer. Marker of cell proliferation Nuclear stain; cytoplasmic staining is disregarded Used to help differentiate between benign versus malignant and increasingly used to grade various tumors (e.g. Papillary urothelial carcinoma is a type of cancer. The longer follow-up in patients with prior history likely reflects ongoing surveillance protocols in that context. Fletcher MD, FRCPath, in Diagnostic Histopathology of Tumors, 2021 Papillary Urothelial Neoplasm of Low Malignant Potential. A transurethral resection of bladder tumor (TURBT) revealed low-grade papillary urothelial carcinoma without muscle invasion. The percentage of invasive urothelial carcinoma that had myxoid stroma ranged from 5% to 95% (mean, 50%). fusion of papillary stalks. No lamina propria H&E stain. From Libre Pathology. low grade papillary urothelial carcinoma is a slow growing cancer that is unlikely to spread. Muscularis propria negative for tumor. In this current scheme, papillary neoplasms are divided into 4 categories: papilloma, papillary urothelial neoplasm of low malignant potential, low-grade carcinoma (LGUC), and high-grade carcinoma (HGUC). 1 Prognosis in these Ta tumours is determined by histological grade, size, and multiplicity of tumours, early recurrence, and concomitant carcinoma in situ. Pathology Outlines - Mesothelial cyst . In the grading scheme for papillary urothelial tumors proposed by the International Society of Urological Pathology, the lowest of the three grade categories is considered to represent a benign neoplasm that lacks the capacity to invade. recognizable papillary, invasive, or flat carcinoma in situ (CIS) urothelial component being considered as urothelial carcinoma with divergent differentiation. The rest (9 out of 32 neoplasms) were either non-invasive papillary carcinomas of high (non-invasive HG UC, 5 cases) or low malignant potential (noninvasive LG UC, 4 cases). There is a paucity of data on whether CIS-GL diagnosed in the absence of invasive carcinoma is associated with an increased risk of developing small cell carcinoma of the bladder. Christopher D.M. Papillary-Urothelial Carcinoma, High-Grade: Predominantly or totally disorderly appearance at low magnification with both architectural and cytologic abnormalities. Heterologous elements (non-native structures) present in 24% of cases, most commonly osteosarcoma. There were 363 (53%) tumors that were papillary stage pTa. Papillary urothelial neoplasm of low malignant potential is a low-grade papillary urothelial neoplasm with a substantial incidence of recurrence and progression. frequent mitosis, esp high up in epithelium. Low grade papillary urothelial carcinoma. 1 The presence of micropapillary component (MPC) in urothelial carcinoma was found to be associated with high-grade and advanced stage of tumour, though low-grade and non-invasive cases have been reported. 1. Of the FGFR3 alterations Occasional fusing of papillae. lack polarity, maturation. Renal cell carcinoma arises from the proximal renal tubular epithelium. PUNLMP is pronouced "pun-lump". Usually with fusion of papillae and branching of papillae. Architecturally cells appear irregularly clustered and the epithelium is disorganized. The most common cystoscopic findings were papillary tumour (24 cases), papillary irregularity (10 cases), and irregular mucosa (9 cases). Features: Papillae = fibrovascular cores covered by urothelium. Urothelial cancer refers to a cancer of the lining of the urinary system. Squamous papilloma is a rare benign neoplasm seen in the bladder. +/-Invasion into the lamina propria (rare). Visual survey of surgical pathology with 11,493 high-quality images of benign and malignant neoplasms & related entities. Cox and associates reported that a surface component was present in 19 of the 23 cases, with 16 low-grade papillary urothelial carcinomas, 2 low-grade papillary urothelial carcinoma with less than 5% high-grade urothelial carcinoma, and 1 high-grade papillary urothelial carcinoma. Introduction. In the distinction of papillary urothelial neoplasm of low malignant potential from noninvasive low-grade papillary urothelial carcinoma, there is considerable interobserver variability. Urothelial papilloma – are rare benign tumours, accounting for under 1% of papillary urothelial neoplasms. * Denotes primary author. Commonly presents with hematuria. Nuclear pyknosis is The micropapillary variant of urothelial carcinoma is a very rare form of urothelial carcinoma that has been reported in the urinary bladder, 10 ureter 7, 11 and renal pelvis. Tumours that show invasion into the surrounding tissues are associated with a worse prognosis. Papillary Urothelial Carcinoma, Low-Grade. The questions and answers that follow are meant to help you understand medical language you might find in the pathology report from a breast biopsy, such as a needle biopsy or an excision biopsy. Tumors were reviewed and graded according to the 2004 WHO/ISUP classification as papillary urothelial neoplasm of low malignant potential (PUNLMP), low-grade papillary urothelial carcinoma (LPUC), or high-grade papillary urothelial carcinoma (HPUC) Image 1. Fletcher MD, FRCPath, in Diagnostic Histopathology of Tumors, 2021 Papillary Urothelial Neoplasm of Low Malignant Potential. cytologic atypia, pleomorphism. It is a papillary urothelial neoplasm of low malignant potential (PUNLUMP) [] composed of papillary cores with overlying histologically benign squamous epithelium. In addition, glandular or villogland-ular differentiation of a noninvasive papillary urothelial neoplasm must be excluded by the absent of characteristic urothelial areas (Miller and Epstein 2009; Lim et al. Histologically, renal cell carcinoma can be of various cellular types: clear cell (70% to 80%), papillary (10% to 15%), and chromophobe (5%). Invasive urothelial carcinoma is graded with the same criteria as papillary carcinomas; Invasion by low grade carcinomas is rare but can occur (Toll 2012) Staging. [] reported the incidence of sarcomatoid urothelial carcinoma to have ranged from 02% to 4.3%.The suggested incidence was confirmed in an analysis of the … In the grading scheme for papillary urothelial tumors proposed by the International Society of Urological Pathology, the lowest of the three grade categories is considered to represent a benign neoplasm that lacks the capacity to invade. Papillary Urothelial Carcinoma, Low-Grade. Grading pTa papillary TCC WHO 20_ _ ? This divides bladder cancers into 4 groups: urothelial papilloma means it is a non cancerous (benign) tumour. There is minimal but definitive nuclear atypia that is characterized by hyperchromasia, mild variation of nuclear size and mitoses are infrequent. Urothelial cells also line the urethra, ureters, and other parts of … • Flat urothelial carcinoma in situ, in bladder neck and posterior wall. Papillary Urothelial Carcinoma, Low-Grade. Microscopic (histologic) description. Normal thickness is 4-6 cells. Papillary urothelial hyperplasia, abbreviated PUH, is a benign lesion of the urothelium that is associated with the subsequent development of low-grade papillary urothelial carcinoma. Invasive Tumors . CK5/6 expression on the other hand is expressed in the basal cells in all low-grade and some high-grade urothelial carcinomas. … Sarcomatoid component is frequently composed of hypercellular high-grade spindle cells (undifferentiated spindle cell sarcoma). Positivity in invasive high grade urothelial carcinoma in 80% cases and mets to lung, typically strong and diffuse All high grade prostatic adenocarcinomas were 1 Prognosis in these Ta tumours is determined by histological grade, size, and multiplicity of tumours, early recurrence, and concomitant carcinoma in situ. Cancer originated in the urothelium that forms exophytic or endophytic papillary structures (protrusions with a fibrovascular core) Clinically, it may not be possible to differentiate renal pelvis urothelial carcinoma and renal cell carcinoma. Cancer originated in the urothelium that forms exophytic or endophytic papillary structures (protrusions with a fibrovascular core) … The patient underwent a cystectomy with a continent ileal diversion to the urethra (neobladder). ~75% nested variant of urothelial carcinoma. Chromosome 9p21 is the region which is most commonly altered in the onco-pathogenesis of bladder cancer. Approximately 75% to 80% of UC are papillary and approximately 20% to 25% are CIS. Overlying surface may show usual urothelial carcinoma in situ, papillary carcinoma or micropapillary carcinoma Invasive if there is irregularity of broad front of bulbous invaginations, retraction … The grade of papillary urothelial carcinomas with both the 1973 and 1998 grading methods was associated with stage (P=0.001). Of the patients in the latter group 95 were subdivided into WHO grade 2 and 13 into WHO grade 3. Papillary urothelial neoplasm of low malignant potential (PUNLMP). Small nuclei (~3x a resting lymphocyte). Focused Papillary Urothelial Neoplasms I with stained slides of pathology. or dysplasia (cervical intraepithelial neoplasia, anal intraepithelial neoplasia, dysplasia arising in … p16 is the most important gene which is either deleted or mutated in this process. Bladder, ureter & renal pelvis - Urothelial neoplasms-noninvasive - Noninvasive papillary urothelial carcinoma low grade. CK5/6 expression on the other hand is expressed in the basal cells in all low-grade and some high-grade urothelial carcinomas. The most common type of bladder tumour in the Western world is a non-invasive, papillary tumour, which accounts for approximately 45% of all primary bladder tumours. The kidneys work by removing waste products from the blood. Exophytic lesion. The tumors were classified as papillary urothelial neoplasm of low malignant potential in 95 patients, low grade papillary urothelial carcinoma in 160 and high grade carcinoma in 108. The pathology report says that I have Stage T1, with two types of cancer present: • High-grade papillary urothelial carcinoma in right lateral wall.