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Classification and grading of the non-invasive urothelial neoplasms: recent advances and controversies

¹ Institute of Pathological Anatomy and Histopathology, Ancona University School of Medicine, I-60020 Torrette, Ancona, Italy
² Department of Pathology, Reina Sofia University Hospital and Faculty of Medicine, 14071 Cordoba, Spain
³ Bostwick Laboratories, Richmond, and University of Virginia, Charlottesville, VA 23294 Virginia, USA

Correspondence to:
Professor R Montironi, Institute of Pathological Anatomy and Histopathology, University of Ancona School of Medicine, Umberto 1° Hospital, I-60020 Torrette, Ancona, Italy;
r.montironi{at}unian.it
ABSTRACT
The classification and grading of the non-invasive, intraepithelial neoplasms of the urothelium are based on the morphological pattern of growth—that is, papillary or flat (and endophytic)—and on their degree of architectural and cytological abnormalities. Recent advances in the morphological, molecular, and quantitative evaluation of these lesions have contributed to the refinement of the current classification and grading schemes. However, some controversies on the precise criteria and terminology, especially when the papillary lesions are concerned, are still present.

Keywords: urothelium; urothelial papillary carcinoma; urothelial hyperplasia; malignancy associated change; dysplasia; carcinoma in situ

Abbreviations: CIS, carcinoma in situ; G, grade; ISUP, International Society of Urological Pathology; LOH, loss of heterozygosity; PUNLMP, papillary urothelial neoplasm of low malignant potential; WHO, World Health Organisation

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