Qap (Anatomical Pathology) 

QAP Peer Review

AP117
Case History: F/76 with dysuria and extending erythrematous plaque on cystoscopy over the past 2 years. Cystectomy was performed.
Intended diagnosis: Intestinal metaplasia with severe dysplasia. Contributed by:FML
Code Diagnosis Comment Score
anonymous Adenocarcinoma in-situ with background intestinal metaplasia 100% Advise more extensive sampling to exclude invasive malignancy.  100
anonymous Adenocarcinoma, 100% nil  100
anonymous Cystitis glandularis with severe epithelial dysplasia, 100% More blocks should be sampled to look for evidence of overt malignancy.  100
anonymous URINARY BLADDER : VILLOUS ADENOMA with SEVERE DYSPLASIA and focal areas suspicious of early stromal invasion (100%). Serial deeper sectioning is recommended because focal areas are suspicious of early stromal invasion.  100
anonymous Primary adenocarcinoma and adenocarcinoma-in-situ (100%) nil  100
anonymous Villous adenoma with moderate dysplasia, 100% Extensive sampling for presence of stromal invasion.  95
anonymous Adenocarcinoma. 100% nil  100
anonymous Adenocarcinoma arising from extensive intestinal metaplasia. (100%) nil  100
anonymous Bladder - villous adenoma, severe dysplasia / carcinoma-in-situ 100% Adequate sampling to exclude invasive tumour  100
anonymous Intestinal metaplasia with dysplasia and focal stromal invasion (100%) Deeper section and additional blocks to assess for extent of invasion.  100
anonymous Villous adenoma with severe dysplasia 100% Further sampling to exclude carcinoma in-situ  100
anonymous Adenocarcinoma in situ. 100% nil  100
anonymous Papillary adenocarcinoma in-situ of urinary bladder with focal intramucosal adenocarcinoma 100% 1. Patchy (cystitis glandularis) intestinal metaplasia with varying degree of dysplasia. There is very focal complex glandular morphology without desmoplasia nor single cell invasion (intramucosal adenocarcinoma). 2. May be associated with transitional cell carcinoma (in-situ or invasive) elsewhere especially small cell and micropapillary type. (In Situ Adenocarcinoma of the Bladder. Theresa Y Chan, et al. Am J Surg Pathol 25(7): 892-899, 2001)  100
anonymous Adenocarcinoma (100%) Carcinoma-in-situ (100%) nil  100
anonymous Adenocarcinoma arising from villous adenoma, early invasion. Probability : 100% nil  100
anonymous Adenocarcinoma in-situ (100%) Additional blocks should be examined to exclude invasion.  100
anonymous Urinary bladder - Adenocarcinoma in-situ with superficial stromal invasion. nil  100