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Nicht-invasive und invasive Urothelneoplasien

Besondere Herausforderungen in der uropathologischen Diagnostik

Non-invasive and invasive urothelial tumours

Special challenges in uropathological diagnostics

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  • 6 Citations

Zusammenfassung

Mit der aktuell gültigen WHO-Klassifikation der Harnblasenkarzinome von 2004 wurden sowohl nicht-invasive als auch invasive Neoplasien anhand der Zellmorphologie und den zugrunde liegenden genetischen Veränderungen hinsichtlich prognostisch relevanter Gruppen neu kategorisiert. Obwohl weite Teile der Klassifikation unverändert blieben, führten in den letzten Jahren kleine wesentliche Änderungen jedoch häufig zu Unsicherheiten und primärer Skepsis gegenüber den Neuerungen bei Urologen und Pathologen. Der vorliegende Artikel bietet eine Übersicht über die aktuelle WHO-Klassifikation mit Schwerpunkt auf Herausforderungen in der uropathologischen Diagnostik, mit denen sich die Uropathologen, und daher auch die behandelnden Urologen, auseinandersetzen müssen. Diese Herausforderungen umfassen u. a. uneindeutige Befunde, schwierige Differentialdiagnosen und seltenere Differenzierungen mit entsprechenden Formulierungen/Ausdrücken im pathologischen Befund sowie deren Bedeutung bzw. Auswirkung für die Praxis (weitere Abklärung, Prognose, Therapie).

Abstract

The current 2004 WHO classification of bladder tumors categorizes non-invasive and invasive urothelial neoplasms into prognostically relevant groups according to the histopathological cell morphology and underlying genetic changes. Although many parts of the classification have not been changed dramatically, even small changes have caused uncertainty and scepticism among urologists and pathologists in recent years. The following review article is structured into various challenges for urologists and pathologists and provides an overview of rare but clinically relevant subgroups and diagnostics, interpretation of diagnoses and pathological findings with respect to consequences for the daily clinical routine (extended diagnosis, therapy and prognosis).

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Correspondence to Dr. K. Lindemann-Docter.

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Gaisa, N., Lindemann-Docter, K. Nicht-invasive und invasive Urothelneoplasien. Urologe 52, 949–957 (2013). https://doi.org/10.1007/s00120-013-3225-2

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Schüsselwörter

  • Harnblasenkarzinome
  • Varianten
  • WHO-Klassifikation
  • Pathologischer Befund

Keywords

  • Bladder cancer
  • Variants
  • WHO classification
  • Pathology report