Histopathology report

Renal pelvis and ureter

• tumour type - transitional/squamous/adenocarcinoma/other.

• tumour differentiation - WHO grades I-III.

1. non-invasive (pure) - papillary/flat CIS/papillary and flat CIS.

3. mixed, non-invasive and invasive.

4. indeterminate.

- pTa non-invasive papillary carcinoma.

- pTis carcinoma in situ.

- pT1 tumour invades subepithelial connective tissue.

- pT2 tumour invades the muscularis.

- pT3 (for renal pelvis only) tumour invades beyond muscularis into peripelvic fat or the renal parenchyma.

- pT3 (for ureter only) tumour invades beyond muscularis into periureteric fat.

- pT4 tumour invades adjacent organs, or through the kidney into the perinephric fat.

• lymphovascular invasion - present/not present. Note perineural invasion.

• regional lymph nodes - those within the true pelvis; all others are distant nodes.

- pN0 no regional lymph node metastasis.

- pN1 metastasis in a single lymph node, < 2 cm in greatest dimension.

- pN2 metastasis in a single lymph node, > 2 cm but < 5 cm in greatest dimension, or multiple lymph nodes, none > 5 cm in greatest dimension.

- pN3 metastasis in a lymph node > 5 cm in greatest dimension.

• margins: ureteral, bladder neck, Gerota's fascia (perinephric fat margin), hilar soft tissue, renal parenchyma (partial nephrectomy) tumour clearance (mm).

• additional pathologic findings, if present: carcinoma in situ (focal/multifocal), dysplasia, inflammation/regenerative changes, therapy related (BCG, mitomycin).

• other pathology: cystitis cystica glandularis, keratinising squamous metaplasia, intestinal metaplasia.

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