Urology dataset Flashcards
Penile specimen
opening - longitudinal ink margin Orientate mention number of tumour, size, thickness, location, relationship to meatus, corporal head, sulcus other abnormality
Penile block
Tumour Max extent, width and depth distance to nearest margin margins of resection (urethral, periurethral, corpus cavernosum, circumferential, peripheral skin, deep soft tissue background tissue
if circumcision - all tissue should be taken if concerned
Penile micro
Tumour type SCC (95%), sarcoma, NEC, melanoma papillary vs verrucous Basaloid, acantholytic, sarcomatoid (grade 4) Staging pT1a (low risk), T1b (high risk) pT2 invasion to spongiosum pT3 invaison to cavernosum pT3 LVSI Perineural invasion
PeIN
In situ SCC
warty/basaloid + full thickness = undifferentiated (p16)
basal cell atypia + architecture atypia + keratin = differentiated (usually seen with LS)
Prostate radical resection
Weight Vas margins Seminal vesicles Apex and base sliced perpendicular to urethra Embed all
Prostate enucleation/TURP
Weight Embed all if under 12g furthe block every 5g Less than 5% = T1a More than 5% = T1b
histological grading
Gleason score
resection - Most common + 2nd most common
Biopsy - most common + highest grade
Prostate IHC
34betaE12, CK5 or p63 for basal cells
Racemase/AMACR - overexpressed in prostate ca
Prostate staging
pT1 - only biopsy pT2a - one 1/2 lobe pT2b - one lobe pT2c - two lobes T3a - extraprostatic extension T3b - seminal vesicle involvement T4 - locally invasive N1 - regional LN M1a non regional LN M1b Bone met M1c elsewhere
Urothelial carcinoma - renal pelvis
Blocks
ureteric margin vascular margin crosssection of ureter at 10mm adrenal gland normal renal parenchyma normal renal pelvis deepest point of invasion fat/renal parenchyma ureteric tumour hilar LN para-aortacaval LN
Urothelial carcinoma - cystectomy
blocks
ureteric urethral margins deepest invasion mucosal abnormality suspicious area from imaging prostate and SV uterus, cervix and vagina LNs
Tumour classification and grade - urothelial carcinoma
key micro
Grade 1 PUNLMP Grade 1 LG Grade 2 LG Grade 2 HG Grade 3 HG
CIS or no CIS
LVSI
Staging urothelial - renal pelvis
pTx, pT0 pTa - Non invasive papillary carcinoma pTis pT1 - connective tissue pT2 - muscularis pT3 - renal pelvis + fat pT4 - adjacent organ including kidney
pN1 - 1 LN <2cm
pN2 - 1 LN >2cm or 2LNs
pN0i - with IHC <0.2mm
pN1mi - with IHC >0.2mm
Staging urothelial bladder
pTx, pT0 pTa - Non invasive papillary carcinoma pTis pT1 - connective tissue pT2a - inner half muscularis pT2b - outer half muscularis pT3a - micro involvement pT3b - macro involvement pT4a - adjacent organ pT4b - pelvic wall or abdo wall
pN1 - 1 LN
pN2 - >1 LNs
pN3 - common iliac LNs
pM1a - non regional LN
pM1b -distant met
