Carcinoma in situ (CIS) of the urinary bladder is defined as a flat lesion comprising of cytologically malignant cells which may involve either full or partial thickness of the urothelium. De novo CIS constitutes less than 3% of all urothelial neoplasms; however, CIS detected concurrently or secondarily during follow-up of urothelial carcinoma constitutes 45% and 90%, respectively, of bladder cancer. CIS is noted predominantly in male smokers in the sixth or seventh decade. Patients may present with dysuria, nocturia, and urinary frequency and urgency with microscopic hematuria. Cystoscopic findings may range from unremarkable to erythema or edema. Urine cytology is an important diagnostic tool. Cellular anaplasia, loss of polarity, discohesion, nuclear enlargement, hyperchromasia, pleomorphism, and atypical mitoses are the histopathologic hallmarks of CIS. Extensive denud ation of the urothelium, monomorphic appearance of the neoplastic cells, inflammatory atypia, radiation induced nuclear smudging, multinucleation, and pagetoid spread of CIS may cause diagnostic difficulties. Together with clinical and morphologic correlation, immunostaining with CK 20, p53 (full thickness), and CD44 (absence of staining) may help accurately diagnose CIS. Fluorescent in situ hybridization analysis of voided urine for amplification of chromosomes 3, 7, and 17 and deletion of 9p has high sensitivity and specificity for diagnosing CIS in surveillance cases. Several other molecular markers, such as NMP 22 and BTA, are under evaluation or used variably in clinical pathology. Intravesical bacillus Calmette-Guerin (BCG) instillation is considered the preferred treatment, with radical cystectomy being offered to refractory cases. Chemotherapy, α-interferon, and photodynamic therapy are other modalities that can be considered in BCG-refractory cases. Multifocality, involvement of prostatic urethra, and response to BCG remain the most important prognostic factors, although newer molecular markers are being evaluated for this entity. Patient outcome varies based on whether it is de novo development or diagnosed secondary to prior or concomitant papillary bladder cancer. From a clinical perspective, the principal determinants of outcome are extent of disease, involvement of prostatic urethra, response to therapy, and time to recurrence.
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Nalan Nese, Ruta Gupta, Matthew H. T. Bui, and Mahul B. Amin
Edited by Kerrin G. Robinson
Daniel Simmons, Yang Xiao, Corina Roca, Zhuoxin Jiang, and Marnie Boron
Ran Jin, Neil Accortt, Darcie Sandschafer, Tatiana Lawrence, and Reshma Mahtani
Kavea Panneerselvam, Rajan N. Amin, Dongguang Wei, Dongfeng Tan, Phillip J. Lum, Hao Chi Zhang, David M. Richards, Mehmet Altan, Petros Grivas, John A. Thompson, Anusha S. Thomas, and Yinghong Wang
knowledge regarding the typical characteristics of ICI-related esophagitis and the appropriate treatments for this condition. In this retrospective study, we aimed to characterize esophagitis associated with the use of ICIs and describe its clinical
Xiaoxiao Lu, Qing Huang, Linda Wu, Bruno Emond, Shaun P. Forbes, Annalise Hilts, Stephanie Liu, Marie-Hélène Lafeuille, Patrick Lefebvre, and Kerry A. Rogers
evaluated time to discontinuation (TTD) and characteristics associated with TTD for first-line (1L) V+G. Methods : The nationwide Flatiron Health electronic health record-derived de-identified database (4/11/15-6/30/21) was used to select adults with CLL
Antoine Eskander, Qing Li, Jiayue Yu, Julie Hallet, Natalie G. Coburn, Anna Dare, Kelvin K.W. Chan, Simron Singh, Ambica Parmar, Craig C. Earle, Lauren Lapointe-Shaw, Monika K. Krzyzanowska, Timothy P. Hanna, Antonio Finelli, Alexander V. Louie, Nicole Look Hong, Jonathan C. Irish, Ian J. Witterick, Alyson Mahar, Christopher W. Noel, David R. Urbach, Daniel I. McIsaac, Danny Enepekides, and Rinku Sutradhar
. Data Sources The analysis was performed using data held at the ICES (previously known as the Institute for Clinical Evaluative Sciences). Demographic characteristics, vital status, and date of death for all individuals covered under the Ontario Health
Megan C. Roberts, Allison W. Kurian, and Valentina I. Petkov
, including race, SES, and age, given the need to more deeply characterize test uptake in these groups over time. Population characteristics were analyzed using chi-square tests. Among those who received the 21-gene assay, kernel density estimates of the RS
Ata S. Moshiri and Paul Nghiem
staining introduced in the 1990s) ( Figure 1 ). 2 MCC characteristically presents as a solitary pink or purple nodule ( Figure 2 ) that typically has several of the features summarized in the mnemonic “AEIOU”: A symptomatic (eg, painless, nonpruritic), E
Ganessan Kichenadasse, John O. Miners, Arduino A. Mangoni, Andrew Rowland, Ashley M. Hopkins, and Michael J. Sorich
outcomes. Baseline age, sex, race, tumor characteristics, serum lactate dehydrogenase and C-reactive protein (CRP) levels, lung immune prognostic index (LIPI), neutrophil-to-lymphocyte ratio, and various subpopulations of white cells were evaluated for
Vijaya Raj Bhatt, Mojtaba Akhtari, R. Gregory Bociek, Jennifer N. Sanmann, Ji Yuan, Bhavana J. Dave, Warren G. Sanger, Anne Kessinger, and James O. Armitage
distinguish between the entities. 4 Clinical characteristics might also be helpful in making the distinction, including no history of CML or myeloproliferative disorder, no evidence of chronic or accelerated phases of CML after induction therapy, and no
