Urothelial Tumors and Pathogenesis

Urothelial tumors can potentially develop anywhere. A differentiating urothelial lining is found in the: (Select all that apply)

Hyperplasia is reversible, but metaplasia is irreversible.

Which of the following is NOT a characteristic of dysplasia?

What are the most common genetic mutations in bladder cancers?

Hyperplasia is easily recognizable histologically.

Dysplasia is characterized by preneoplastic significance, meaning it has a potential to progress to invasive cancer.

Carcinoma in situ is characterized by complete invasion of the wall layer of the urothelium by neoplastic cells without infiltration.

What is the most common symptom of urinary bladder tumors?

Bladder tumors are always single and isolated.

Which of the following is a classification of a bladder tumor based on its invasion into the bladder wall?

Which of the following statements is TRUE about PTIS or CIS?

Which of the following is a classification of bladder tumor based on its growth pattern?

Flat tumors are more prone to invading the wall, while papillary tumors are less prone to invading the wall.

Which of the following is NOT included in the 2022 WHO classification of urothelial tumors?

In situ urothelial carcinoma is more common as a de-novo neoplasm than as a secondary neoplasm associated with invasive carcinoma.

Which of the following is NOT a gross pathological characteristic observed in CIS?

The nuclear anaplasia of CIS cells is equal to that of high-grade carcinoma.

Pagetoid spread, characterized by focal involvement of the urothelial layer, is a common finding in CIS.

The presence of desmosomes in the urothelium is a sign of CIS.

The presence of "clinging CIS" refers to a situation where only a few malignant cells layer over a normal epithelium above and below a neoplastic urothelium.

CIS is easily diagnosed from a urine sample due to the presence of highly atypical cells with a high nuclear-cytoplasmic ratio.

The prognosis of primitive CIS (de novo) is worse than that of secondary CIS associated with invasive carcinoma.

Papillary non-invasive urothelial carcinoma has a significantly lower rate of progression to invasive carcinoma compared to papillary/flat invasive urothelial carcinoma.

The desmoplastic stromal reaction observed in invasive urothelial carcinoma is a sign of tumor infiltration into the stroma.

What is the region between the epithelium and vessels in the bladder wall?

Which of the following layers of the bladder wall contains small thin fascicles of smooth muscle cells?

Which layer of the bladder wall is characterized by large fascicles of smooth muscle cells?

The muscularis mucosae and muscular wall are both easily distinguished under a microscope.

PTIs refers to a tumor in the epithelial region of the bladder, while pT1 refers to a tumor invading the lamina propria.

PT1 tumors are generally associated with a good prognosis.

The treatment of pT1 tumors typically involves the instillation of Calmette Guerin bacillus and mitomycin.

All pT1 tumors respond to the aforementioned treatment regimen.

The stratifying of pT1 patients into different categories is based solely on the size of the infiltration (more or less than 1 mm) into the lamina propria.

The presence of desmin is a reliable indicator of muscle tissue invasion.

PT3 tumors are known to infiltrate the perivesical tissue, which is the tissue surrounding the bladder.,

Infiltration into the prostate or seminal vesicles in men would be classified as a pT2 tumor.

The papillary variant of urothelial carcinoma is the most common and fascinating variant.

The grading in papillary urothelial carcinoma is based solely on the size of the tumor.

In grade 1 papillary urothelial carcinoma, invasion is uncommon.

The old classification system of papillary urothelial carcinoma relied on a single grade, while the new classification uses a "low" and "high" grade system.

Urothelial papilloma is a cancerous tumor.

Papillary neoplasm of low malignant potential (PUNLMP) is a rare type of bladder tumor.

PUNLMP has an excellent prognosis, comparable to benign tumors.

Papillary urothelial carcinoma, low grade, is a rare type of bladder tumor.

Papillary urothelial carcinoma, high grade, is characterized by the fusion of papillae.

The most common type of papillary urothelial carcinoma is low grade.

The prognosis of low-grade papillary urothelial carcinoma is significantly worse than that of high-grade papillary urothelial carcinoma.

High-grade papillary urothelial carcinoma frequently metastasizes.

Early diagnosis with urinary cytology is highly effective in detecting low-grade papillary urothelial carcinoma but less effective in detecting high-grade papillary urothelial carcinoma.

After a diagnosis of high-grade pT2 urothelial carcinoma, complete remission is the most likely outcome.

The standard treatment for a patient with high-grade urothelial carcinoma involves a combination of systemic chemotherapy and radical cystectomy.

What is the most accurate method for obtaining tissue samples for the diagnosis and staging of bladder cancer?

The TUR-B technique provides large, well-oriented fragments of the tumor, ensuring complete removal of the lesion.

The TUR-B technique is generally considered a reliable method for accurate staging of bladder cancer.

The TUR en-bloc resection technique involves removal of the mucosa, submucosa, and muscularis propria, providing a comprehensive sample for analysis.

The TUR en-bloc resection is typically preferred for small, superficial tumors.

The cartoon image of a whole lesion allows for the evaluation of both peripheral and deep margins, helping predict the rate of tumor progression.

Histological images provide sufficient details to determine the depth of tumor infiltration into the lamina propria, mucosa, and muscle wall.

Which of the following factors is NOT associated with an unfavorable prognosis in urothelial carcinoma.