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Review
. 2022 Feb;115(1):32-40.
doi: 10.32074/1591-951X-838. Epub 2023 Jan 25.

News in the classification of WHO 2022 bladder tumors

Maria Rosaria Raspollini  1 , Eva M Comperat  2 , Antonio Lopez-Beltran  3 , Rodolfo Montironi  4 , Alessia Cimadamore  5 , Toyonori Tsuzuki  6 , George J Netto  7
Affiliations
Review

News in the classification of WHO 2022 bladder tumors

Maria Rosaria Raspollini et al. Pathologica. 2022 Feb.

Abstract

The fifth-edition of World Health Organization (WHO) Classification of Tumors series for urinary and male genital tract tumors has been published, six years later the fourth-edition. In these years, new treatment approaches have been implemented and new molecular data on urological cancers are known.

Morphology remains the groundwork for taxonomy of the urinary tract tumors. However, a molecular approach to classification of urothelial carcinomas and the management of selected neoplasms with new therapeutic modalities such as immunotherapy are emerging. More data are needed for the application of these advances in routine pathology practice and patient management.

The 2022 World Health Organization (WHO) Classification of Tumors of the Urinary System and Male Genital Organs represents an update in classification on urinary tract tumors. It also offers new insights with regards to the grading of heterogeneous non-invasive urothelial neoplasms, the definition of inverted neoplasms, the grading of invasive urothelial carcinomas, the diversity of morphological appearance of urothelial carcinomas, the definition of precursor lesions and the lineage of differentiation of the tumors.

Keywords: WHO 2022; bladder; grading; molecular subgroups; urothelial tumors.

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Conflict of interest statement

The authors declare no conflict of interest.

MRR, EMC, TT and GJN served as expert members in 2022 WHO Classification of Tumours Editorial Board. Urinary and male genital tumours.

Figures

Figure 1a.
Figure 1a.
Papillary urothelial carcinoma, low grade, with a focus of low-grade urothelial carcinoma invading lamina propria.
Figure 1b.
Figure 1b.
Papillary urothelial carcinoma, high grade, invading lamina propria.
Figure 2a.
Figure 2a.
Urothelial carcinoma with trophoblastic differentiation. Tumor with syncytiotrophoblasytic cells.
Figure 2b.
Figure 2b.
Urothelial carcinoma with trophoblastic differentiation. Beta-hCG stain positive in syncytiotrophoblasytic cells.
Figure 3.
Figure 3.
Microcystic urothelial carcinoma. Presence of cystic structures infiltrating a non-reactive stroma.
Figure 4.
Figure 4.
Micropapillary urothelial carcinoma. Tumor with micropapillary architecture.
Figure 5a.
Figure 5a.
Lymphoepithelioma-like urothelial carcinoma.
Figure 5b.
Figure 5b.
Lymphoepithelioma-like urothelial carcinoma. Sheet of CK7 positive cells with a syncytial feature.
Figure 6.
Figure 6.
Lipid-rich urothelial carcinoma. Tumor cells with a lipoblast-like appearance.
Figure 7.
Figure 7.
Plasmacytoid urothelial carcinoma. Dyscoesive and plasmacytoid-appearance tumor cells invading the perivesical fat.
Figure 8.
Figure 8.
Clear cell (glycogen-rich) urothelial carcinoma. Sheet of cells with clear cytoplasm invading the muscle.
Figure 9.
Figure 9.
Sarcomatoid urothelial carcinoma. Spindle tumor cells with high grade atypia.
See this image and copyright information in PMC

References

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    1. WHO Classification of Tumours Editorial Board. Urinary and male genital tumours. Lyon (France): IARC Press; 2022. (WHO classification of tumours series, 5th ed.; vol. 8).
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