What Does This Cytology And Pathology Report Of Bladder Indicate?
on 2/13/2015
Questions.
1.What is going to be the next course of action.
CYTOLOGY REPORT AND PATHOLOGY REPORT
2/17/2015
Final Diagnosis:
Cytospin smears, urine for cytology:
-POSITIVE for malignant cells.
-Cytologic features consistent with high-grade urothelial carcinoma.
Comment:
Please see also concurrent bladder biopsy (S15-4016).
Ancillary Studies:
None
Gross Description:
Labeled with the patient’s name, medical record number, urine for
cytology, consisting of 95 mL of yellow to clear fluid. A Diff-Quik
stained air-dried cytospin smear and two Pap stained alcohol-fixed
cytospin smears are prepared.
Clinical History:
History of bladder cancer in situ. The patient is also status post
bladder biopsy on 2/13/2015 which showed a high-grade papillary
urothelial carcinoma invading the lamina propria (S15-4016).
Immediate Assessment:
None
PATHOLOGY
Final Diagnosis:
A- Bladder biopsy:
-Small fragment of urothelial mucosa with acute and chronic
inflammation.
-No evidence of malignancy.
B- Bladder mass:
-High grade papillary urothelial carcinoma invading the lamina propria
and thick muscle bundles.
-Focal lymphatic invasion.
Comment:
Case discussed with Dr. XXXXXXX on February 17, 2015 at 1:18 PM.
Dr. Farolan has reviewed the case and concurs with the above diagnosis.
Ancillary Studies:
None
Gross Description:
A- Labeled with the patient’s name, medical record number, bladder
biopsy, received in formalin: Specimen consists of four pieces of
orange to yellow-tan tissue, each measures 0.2 cm in greatest dimension.
The specimen is submitted in toto in cassette A.
B- Labeled with the patient’s name, medical record number, bladder
tumor, received in formalin: Specimen consists of multiple pieces of
orange to yellow-tan tissue measuring in aggregate 5.0 × 2.8 × 0.4 cm.
The specimen is wrapped in lens paper and submitted in toto in cassettes
B1-B3.
Clinical History:
History of bladder cancer in situ, malignant neoplasm of bladder, part
unspecified
Intraoperative Diagnosis:
None
Read detail answer below.
Detailed Answer:
Hello
Thanks for your query,based on the facts and recent histopathology reports of bladder that you have posted it appears that the tumor has infiltrated in muscles of the bladder and surrounding tissue .
After going through our previous threads and the present reports It is certain that the cancer of the bladder has spread beyond the mucosa .
Doing local resection and intra vasical installation with BCG or interferon will not help to arrest the further growth of the cancer.
In a given situation I would advise you to go for radical treatment consisting of Radical Cystectomy with formation of Neo Bladder,
Please get your C.T Scan of the abdomen done to trace out involvement of lymph nodes in abdomen and para aortic region.
Please discuss the technical aspect and further treatment with your Uro- Oncologist,
Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.
It is still confined to badder and has not invaded outside bladder
Detailed Answer:
Hello
Thanks for follow up.Pathology report suggest that it is still confined to bladder but there is focal lymph node invasion .
If neglected it may infiltrate perivasical tissue and may metastasize to distant organs .
Thanks and Regards.
Dr.Patil.
What other options are there?
Other option is Radiotherapy.
Detailed Answer:
Hello
Thanks for follow up.
Other option to Radical Cystectomy is Radiotherapy.
You have to discuss the feasibility with your Uro Oncologist keeping in mind the side effects of radiotherapy.
Thanks and Regards.
Dr.Patil.