Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 4.
doi: 10.1097/PAP.0000000000000510. Online ahead of print.

The Dublin International Society of Urological Pathology (ISUP) Consensus Conference on Best Practice Recommendations on the Pathology of Glandular Lesions of the Urinary Bladder

Gladell P Paner  1 , Hikmat Al-Ahmadie  2 , Nadine T Gaisa  3   4 , Antonio Lopez-Beltran  5 , Fiona Maclean  6 , Toyonori Tsuzuki  7 , Isabela Werneck da Cunha  8 , Mahul B Amin  9   10 , Jonathan Aning  11 , Manju Aron  12 , Daniel Athanazio  13   14 , Richard M Bambury  15 , Liang Cheng  16 , Anuradha Gopalan  2 , Christian Gulmann  17 , Charles C Guo  2 , Carole Harris  18   19 , Gopa Iyer  20   21 , Rafael E Jimenez  22 , Masahiro Jinzaki  23 , Eiji Kikuchi  24 , Priti Lal  25 , Kosuke Miyai  26 , George J Netto  25 , Chin-Chen Pan  27 , Valeria Panebianco  28 , Bas Wg van Rhijn  29   30   31 , Arlene Siefker-Radtke  32 , Steven C Smith  33 , Tibor Szarvas  34   9   35 , Sara E Wobker  36 , Glen Kristiansen  37 , Henning Reis  38 ; ISUP Expert Panel On Urachal Neoplasms and Urinary Bladder Glandular Lesions
Collaborators, Affiliations

The Dublin International Society of Urological Pathology (ISUP) Consensus Conference on Best Practice Recommendations on the Pathology of Glandular Lesions of the Urinary Bladder

Gladell P Paner et al. Adv Anat Pathol. .

Abstract

The Dublin ISUP Consensus Conference covered the proceedings on the best practice recommendations on nonurachal glandular lesions of the urinary bladder, bladder diverticular cancers, and molecular features of bladder and urachal glandular lesions. The conference proceedings on urachal neoplasms (except for their molecular features) are published elsewhere. The rationale for convening this conference was the lack of structured and consented pathologic recommendations in these rare lesions. Consensus by participants was reached on the following statements: (1) intestinal metaplasia with dysplasia is considered to be a precursor to primary bladder adenocarcinoma; (2) dysplasia arising from cystitis glandularis should be reported in terms of focality (focal or nonfocal) and grade (low or high); (3) the term "adenocarcinoma" should only be used for carcinomas showing pure (nonurothelial) morphology and should not be used interchangeably in urothelial carcinoma with "glandular differentiation" because of the pathobiological differences and management implications; (4) the different histologic subtypes of bladder adenocarcinoma should be specified in the report; (5) immunohistochemistry has an ancillary role in the work up of bladder adenocarcinoma versus gastrointestinal or Müllerian-type adenocarcinomas; (6) lymphovascular invasion should be included as a parameter when reporting bladder adenocarcinoma; (7) representative or targeted sampling will be sufficient for bladder diverticulum resection specimens; and (8) molecular analysis in genomic profiling should be performed only in advanced or metastatic bladder and urachal adenocarcinomas for targetable therapy. This report on glandular (nonurachal) lesions of the bladder from the Dublin ISUP consensus conference will serve as a best practice recommendation and as a guide for future research on these relatively rare lesions.

Keywords: ISUP; Müllerian; adenocarcinoma; bladder; consensus; glandular; intestinal; urachal.

PubMed Disclaimer

Conflict of interest statement

The authors have no funding or conflicts of interest to disclose.

References

    1. Reis H, Al-Ahmadie H, Gasia NT, et al. The Dublin International Society of Urological Pathology (ISUP) consensus conference on best practice recommendations on the pathology of urachal neoplasms. Am J Surg Pathol. 2025. doi:10.1097/PAS.0000000000002440. Online ahead of print. - DOI
    1. Comperat E, Srigley JR, Brimo F, et al. Dataset for the reporting of carcinoma of the bladder-cystectomy, cystoprostatectomy and diverticulectomy specimens: recommendations from the International Collaboration on Cancer Reporting (ICCR). Virchows Arch. 2020;476:521–534.
    1. Harik LR, Paner GP, HA Al-Ahmadie, et al. Protocol for the examination of cystectomy specimens from patients with carcinoma of the urinary bladder. Accessed February 28, 2025. https://www.cap.org/protocols-and-guidelines.
    1. Harik LR, Paner GP, HA Al-Ahmadie, et al. Protocol for the Examination of Biopsy and Transurethral Resection of Bladder Tumor (TURBT) specimens from patients with carcinoma of the urinary bladder. Accessed February 28, 2025. https://www.cap.org/protocols-and-guidelines.
    1. American Joint Committee on Cancer. AJCC Cancer Staging Manual, Eight Edition. Springer Nature, Switzerland. 2017.

LinkOut - more resources