Case ID: 171

Publication date: 18 Nov, 2015

Consensus grade: Carcinoma in situ (CIS)

User Diagnosis Difficulty Comment
Pathologist 1 Carcinoma in situ (CIS) Typical
Pathologist 2 Reactive atypia Borderline higher
Pathologist 3 Carcinoma in situ (CIS) Typical
Pathologist 4 Carcinoma in situ (CIS) Typical
Pathologist 5 Atypia/dysplasia Borderline higher

Quality of pics is poor

Pathologist 6 Carcinoma in situ (CIS) Typical
Pathologist 7 Reactive atypia Borderline higher

Needs IHCH

Pathologist 8 Carcinoma in situ (CIS) Typical
Pathologist 9 Carcinoma in situ (CIS) Typical
Pathologist 10 Carcinoma in situ (CIS) Typical
Pathologist 11 Atypia/dysplasia Borderline higher
Pathologist 12 Carcinoma in situ (CIS) Typical
Pathologist 13 Carcinoma in situ (CIS) Borderline lower
Pathologist 14 Carcinoma in situ (CIS) Typical
Pathologist 15 Reactive atypia Typical

No specific comment.

Pathologist 16 Carcinoma in situ (CIS) Typical
Pathologist 17 Carcinoma in situ (CIS) Typical
Pathologist 18 Carcinoma in situ (CIS) Typical
Pathologist 19 Carcinoma in situ (CIS) Bordering on lower
Pathologist 20 Carcinoma in situ (CIS) Typical
Pathologist 21 Atypia/dysplasia Bordering on higher
Pathologist 22 Carcinoma in situ (CIS) Typical

Some of the atypical urothelial cells present have high nuclear:cytoplasmic ratio raising the possibility of at least some element of so-called 'small cell' urohtlelial CIS (not meant to imply neuroendocrine differentiation).



Case description (by case creator):

The degree of cytologic atypia and loss of polarity is disproportionate to the inflammation present in the lamina propria and the degree of atypia is greater than would be acceptable for reactive atypia.