Bladder Biopsy Interpretation

1. Gross Anatomy and Normal Histology



a. Normal urothelium
b. Muscularis mucosa
c. Muscularis propria


2. Inflammatory condition: Non-infectious



a. Interstitial cystitis
b. Follicular cystitis
c. Eosinophilic cystitis
d. Hemorrhagic cystitis
e. Polypoid cystitis
f. Post-transurethral resection granulomas


3. Inflammatory Conditions: Infectious



a. Malakoplakia
b. Schistosomiasis
c. BK virus infection
d. Condyloma


4. Flat Urothelial Lesion



a. Flat hyperplasia
b. Dysplasia
c. Carcinoma in situ
d. Reactive urothelial atypia


5. Papillary Urothelial Lesions



a. Papillary urothelial hyperplasia
b. Papilloma
c. Papillary urothelial neoplasm of low malignant potential
d. Non-invasive low-grade papillary urothelial carcinoma
e. Non-invasive high-grade papillary urothelial carcinoma


6. Urothelial Lesions with Inverted Growth Pattern



a. Proliferation of Von Brun’s nests
b. Inverted urothelial papilloma
c. Urothelial carcinomas with inverted pattern


7. Variants of Urothelial Carcinoma



a. Nested
b. Lymphoepithelioma-like
c. Micropapillary
d. Giant cell
e. Clear cell
f. Plasmacytoid
g. Rhabdoid
h. Undifferentiated
i. Mixed (glandular, squamous)


8. Primary Glandular Lesions



a. Cystitis cystica et cystitis glandularis
b. Villous adenoma
c. In situ adenocarcinoma
d. Invasive adenocarcinoma


9. Squamous Lesions



a. Squamous metaplasia
b. Squamous papilloma
c. Squamous cell carcinoma in situ
d. Invasive squamous cell carcinoma
e. Verrucous carcinoma


10. Miscellaneous Benign Entities



a. Amyloidosis
b. Ectopic prostatic tissue
c. Pneumatosis
d. Endocervicosis
e. Endometriosis


11. Neuroendocrine Neoplasms



a. Paraganglioma
b. Small cell carcinoma


12. Benign Mesenchymal Lesions



a. Pseudosarcomatous fibromyxoid tumor
b. Post-TUR spindle cell nodule
c. Hemangioma
d. Leiomyoma
e. Neurofibroma


13. Malignant and Potentially Malignant Mesenchymal Lesions
Including Mixed Epithelial Mesenchymal Malignancies



a. Carcinosarcoma (sarcomatoid carcinoma)
b. Angiosarcoma
c. Hemangiopericytoma
d. Leiomyosarcoma
e. Malignant fibrous histiocytoma
f. Rhabdomyosarcoma
g. Solitary fibrous tumor


14. Secondary Tumors Involving the Bladder



a. Lymphoma
b. Metastases and direct extension from other tumors


15. Treatment-Related Effects



a. Radiation
b. Chemotherapy