The largest study, with more than 150 patients, showed that the vast majority of patients had PUNLMP
(40.3%), furthermore, UBC could be highly aggressive in 18% of high-grade and muscle-invasive type tumors (9).
The 1973 World Health Organization and 2004 World Health Organization/International Society of Urological Pathology consensus classifications 1973 WHO grading system Urothelial papilloma Grade 1: Well differentiated Grade 2: Moderately differentiated Grade 3: Poorly differentiated 2004/2016 WHO grading system Urothelial papilloma (papillary lesions) (completely benign lesion) PUNLMP
Low-grade papillary UC High-grade papillary UC PUNLMP
; papillary urothelial neoplasm of low malignant potential; UC: urothelial carcinoma; WHO: World Health Organization TABLE 3.
TIP30 expression did not differ significantly between PUNLMP
and LG BUC ( P = 0.97), however, it was significantly reduced in HG BUC compared with PUNLMP
( P < 0.05) and LG BUC ( P < 0.05).
When the differential diagnosis is between UPUMP and papilloma or PUNLMP
, the primary diagnostic feature that distinguishes these lesions is the presence or absence of truly branching papillary fronds.
A cystoscopy, prior to starting the left inguinal orchiectomy, was done (given his history of PUNLMP
) and showed a small subcentimeter hyperemic nodular area in the bladder base, just anterior to the trigone, which was biopsied.
Group Stage n NS FS CS 1 (controls) n 14 6 6 2 PUNLMP
5 1 3 1 2 (low grade) pTa low grade 40 15 18 7 n 45 16 21 8 pTa high grade 7 3 2 2 3 (high grade pTis 2 1 0 1 -non-muscle-invasive) pT1 23 10 6 7 n 32 14 8 10 pT2 20 3 10 7 4 (muscle-invasive) pT3 9 5 4 0 pT4 3 0 2 1 n 32 8 16 8 2-4 (UBC samples) n 109 38 45 26 1-4 (all samples) n 123 44 51 28 CS = current smoker; FS = former smoker; NS = never smoker; PUNLMP
= papillary urothelial neoplasm of low malignant potential.
Long-term outcome of primary Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP
) including PUNLMP
with inverted growth.
Papillary urothelial neoplasms of low malignant potential (PUNLMP
) was found in 4 cases, papillary urothelial carcinoma low grade 29 cases and papillary urothelial carcinoma high grade 11 cases and 9 cases of invasive urothelial carcinoma.
The noninvasive urothelial tumors included papillary urothelial neoplasms of low malignant potential (PUNLMPs
) (7 of 49 [14%]; Figure, A), low-grade, papillary urothelial carcinomas (38 of 49 [78%]; Figure, B), and high-grade, papillary urothelial carcinomas (4 of 49 [8%]; Figure, C).
Both patients underwent uncomplicated transurethral resection and microscopy was consistent with PUNLMP
Differential Diagnosis of Nephrogenic Adenoma Nephrogenic Adenoma Differential Diagnosis Surface lesions (papillary) Urothelial papilloma PUNLMP
Low-grade papillary urothelial carcinoma Involving deep lamina propria Prostatic adenocarcinoma and/or superficial muscle Urothelial carcinoma with bland histology Hobnail cells, solid growth of Clear cell adenocarcinoma of clear cells urinary bladder (rare) Abbreviation: PUNLMP
, papillary urothelial neoplasm of low malignant potential.
(5) It classifies papillary urothelial neoplasms into 4 categories: papilloma, papillary urothelial neoplasm of low malignant potential (PUNLMP
), low-grade papillary urothelial carcinoma (LG-UrCa), and high-grade papillary urothelial carcinoma (HG-UrCa).