Hi Dr Shah - I'm an Anatomical Path Registrar in my first year of training and I just wanted to thank you for your excellent lectures - they have helped me develop my knowledge of genitourinary pathology so much. You are an incredibly gifted teacher.
Thank you sir for the excellent presentation. Can low grade urothelial carcinomas be lamina propria invasive ? Should one be very cautious signing this out as its rare?
That is a great question! In my opinion, low-grade and invasion are oxymoron. I have virtually never signed out invasive low-grade urothelial carcinoma. there are case series, though suggesting such association. Regardless, once the urothelial carcinoma is invades, the grade does not matter.
Excellent presentation. Thank you for posting. I hope you don’t mind me asking a question. TURBT was done for bladder tumor in 62 year old man and on microscopic examination, there are prominent polyploid projections (no true papillae) with marked acute inflammation and exuberant eosinophils in mucosa, submucosa and muscularis propria (no necrosis in the latter). Is eosinophilic cystitis (EC) the correct diagnosis? EC is rare but we recently encountered 3 cases with similar histology making us question this diagnosis. Thank you very much.
Great and difficult question. There are no well-defined objective criteria for eosinophilic cystitis. The diagnosis depends on both combined histopathology and clinical . the presence of exuberant eosinophils that you describe is likely related to that diagnosis. Overall, I would descriptively mention this finding in report and ask them to correlate clinically. Hope this comment is helpful to you.
Great question, Akshay! Keep in mind that dysplasia and CIS are essentially spectrum of lesions. The only way you differentiate between two is based on degree of architectural and cytological atypia. I certainly agree that dysplasia can also potentially exhibit angiogenesis
Differentiation of PUNLMP from Low grade depends on subtle features. PUNLMP is typically characterized by hyperplastic papillae with very minimal cytological and architectural disorder. We have to admit that this distinction is somewhat subjective. I am usually conservative and make this diagnosis in young age patients and meeting strict histological criteria. When you see cells not oriented in a very uniform pattern, that would indicate loss of polarity. Typically characterized by a nuclear crowding and overlap
In paradoxical maturation the invading cells acquire more cytoplasm than surface components. Essentially the invading front has different cytological look than non-invasive front. Hope this is clear to you
i would nominate you for the nobel prize if i could. Wonderful presentation!
Hi Dr Shah - I'm an Anatomical Path Registrar in my first year of training and I just wanted to thank you for your excellent lectures - they have helped me develop my knowledge of genitourinary pathology so much. You are an incredibly gifted teacher.
Thank you very much for your kind words! I appreciate it
Can you send me your notes
Thank you for an exemplary pedagogical and clear lecture! I look forward to watching more from you.
Thank you 🙏!
Your friend Dr. Ming Zhou is my teacher at Tufts MC. Thank you for this lecture!
Thank you for this valuable resource
Like all of your videos. Tremendously helpful! Looking forward to seeing more of your videos.
This lecture is more helpful than any other resources Thank you so much sir!
muchas gracias por estas presentaciones
This was an all-encompassing and very useful resource. Thank you.
Thank you. That was so awesome. Worthy of rapturous attention.
Thank you, Premila! Please share with your colleagues and friends!
Thankyou very much. God bless you and your family.
Thank you very much for your kind wishes!
Thank you Sir. Finally i understood Lamina propria and deep muscle invasion !
excellent. thanks Dr. Shah.
Excellent presentation. Thanks a lot sir !!
outstanding lecture Sir
Thank you! Excellent!
This is great!
Excellent lecture Sir
Awesome video Sir, thank you so much 👍
Thank you, Richa! I appreciate the feedback. Please do share it with your friends and colleagues.
Thanks for Ur efforts sir, wonderful lecture
Thanks, Venkatesh! I appreciate you taking time to provide the feedback
THANK YOU SO MUCH SIR.
Thanks a lot sir. Great presentation.
Thank you, Omer!
Thank u very much.crystal clear lesson.
Thanks for the feedback, Wathsala!
Never understood bladder pathology so well!!! Thanks a lot Sir. Pls also teach Urine cytology
Thank you, Priyanka for your valuable feedback! I appreciate it. There is a video on urine cytology. Please look into the channel content. Thanks
gracias! muy bien explicado y muy practico. muchas gracias.
Thank you!
great video, thank you very much!
Thank you so much for the feedback! I appreciate it
Thank you sir for the excellent presentation. Can low grade urothelial carcinomas be lamina propria invasive ? Should one be very cautious signing this out as its rare?
That is a great question! In my opinion, low-grade and invasion are oxymoron. I have virtually never signed out invasive low-grade urothelial carcinoma. there are case series, though suggesting such association. Regardless, once the urothelial carcinoma is invades, the grade does not matter.
Excellent presentation.
Thank you for posting.
I hope you don’t mind me asking a question.
TURBT was done for bladder tumor in 62 year old man and on microscopic examination, there are prominent polyploid projections (no true papillae) with marked acute inflammation and exuberant eosinophils in mucosa, submucosa and muscularis propria (no necrosis in the latter).
Is eosinophilic cystitis (EC) the correct diagnosis?
EC is rare but we recently encountered 3 cases with similar histology making us question this diagnosis.
Thank you very much.
Great and difficult question. There are no well-defined objective criteria for eosinophilic cystitis. The diagnosis depends on both combined histopathology and clinical . the presence of exuberant eosinophils that you describe is likely related to that diagnosis. Overall, I would descriptively mention this finding in report and ask them to correlate clinically. Hope this comment is helpful to you.
@@rajalbshahExperturologicpath Very helpful. Thank you very much.
Thank you very much
Thank you.
thank u so much
Thank you sir
Thanks sir
sir, in the slide of urothelial dysplasia, there are marked angiogenesis in the base, can it be CIS too?
Great question, Akshay! Keep in mind that dysplasia and CIS are essentially spectrum of lesions. The only way you differentiate between two is based on degree of architectural and cytological atypia. I certainly agree that dysplasia can also potentially exhibit angiogenesis
@@rajalbshahExperturologicpath thank you sir ! Learning everytime i re-see the video
Sir how to differentiate punlmp and low grade papillary urothelial carcinoma.how to identify loss of polarity
Differentiation of PUNLMP from Low grade depends on subtle features. PUNLMP is typically characterized by hyperplastic papillae with very minimal cytological and architectural disorder. We have to admit that this distinction is somewhat subjective. I am usually conservative and make this diagnosis in young age patients and meeting strict histological criteria. When you see cells not oriented in a very uniform pattern, that would indicate loss of polarity. Typically characterized by a nuclear crowding and overlap
Thank you sir
Is any infiltration of the lamina propria considered an invasion? Even if the muscularis mucosae is preserved? Thank you.
That is correct, it is still invasion and would be staged as T1
Amount of lamina propria and depth (above or below muscular is mucosal have potential prognostic difference
Sir can u plz explain paradoxical maturation?
In paradoxical maturation the invading cells acquire more cytoplasm than surface components. Essentially the invading front has different cytological look than non-invasive front. Hope this is clear to you
Thank you so much sir