Thirty-five years of noninvasive bladder carcinoma: a plea for the use of papillary intraurothelial neoplasia as new terminology.
Since the introduction of the World Health Organization (WHO) 1973 terminology for bladder cancer, noninvasive epithelial bladder tumors have consistently been labeled bladder carcinomas. In the WHO 2004 classification the removal of the "carcinoma" label from a small subset of noninvasive bladder carcinomas with indolent behavior created the entity of papillary urothelial neoplasms of low malignant potential, but the remaining noninvasive carcinomas of the urothelial tract retained this label. In this overview, we analyze clinical, pathologic and molecular-genomic findings to support a more evidence-based nomenclature of papillary neoplastic lesions of the urinary tract. In line with the tendency during the last few decades to label flat precancerous lesions of various organs intraepithelial neoplasms, we may now also refer to dysplasia and carcinoma in situ of the urinary tract as low and high grade intraurothelial neoplasia, respectively. To harmonize nomenclature, we now propose that the terms low and high grade papillary urothelial carcinoma be replaced by low and high grade papillary intraurothelial neoplasiafor all noninvasive urothelial cancers.
Van der Kwast
Theodorus H
TH
Department of Pathology and Laboratory Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Ontario, Canada. theo.vdkwast@uhn.on.ca
Zlotta
Alexandre R
AR
Fleshner
Neil
N
Jewett
Michael
M
Lopez-Beltran
Antonio
A
Montironi
Roldolfo
R
D000818:Animals; D002291:Carcinoma, Papillary / Q000145:classification* / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008967:Molecular Biology; D009361:Neoplasm Invasiveness; D011230:Precancerous Conditions / Q000145:classification / Q000473:pathology; D009626:Terminology as Topic; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000145:classification* / Q000235:genetics / Q000401:mortality / Q000473:pathology*