Would one of you "experts" (and you know who you are) please define the following for me, in ten words or less
"Papillary transitional cell carcinoma, Grade II-III/IV"
ps I know what the papillary is, and have read all the stuff on our website info area....Just want a succinct definition of the
II-III/IV to confirm my understanding. Am cleaning out files and just found my initial diagnosis...right before the second TURB which found the (already suspected) CIS. The CIS diagnosis took all of my attention, and I sort of forgot the papillary.
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forgive me...i can't do it in 10 words or less...and YES Virginia there is a Grade I
•The grade of the carcinoma is based primarily on the cytologic features of the epithelium
•Grade I carcinomas closely resemble normal urothelium; usually not more than seven cell layers thick; bland or minimally atypical nuclei and rare mitosis.
•Grade II carcinomas usually show thicker epithelium, i.e., more than 10 cell layers;a moderate degree of nuclear variability in size and chromasia.
•Grade III carcinomas show marked nuclear pleomorphism, readily recognizable mitotic figures; loss of nuclear polarity; and usually show loss of cohesiveness of the epithelial cells.
•Invasion into the lamina propria, muscularis, and lymphatic vessels are important prognostic features
What's grade IV on your definitions? Since Sara Anne was 2-3 on a 4 point scale it would seem like all 4 grades would be helpful.
Sara Anne, I don't know what it means in terms of progression/prognosis. I know the CIS is a much riskier beast. I would guess that a 2-3 on a 4 point scale means medium to medium high risk. CIS is always high risk.
The fact that it was removed and you've been doing BCG treatments and regular checking, my guess is you're doing the right things in terms of what would have the biggest affects on prognosis.
It's been a couple of years and you haven't mentioned it recurring so that's certainly a good sign.
I'd ask your uro about it to be sure. Sorry I can't be of more help.
TCC is arbitrarily graded on a scale of I-III based on the degree of cytologic and architectural abnormalities.
many typical lesions (especially grade III and IV) show foci of squamous differentiation....
I don't know if the pathologists are all on the same page or not when it comes to grading or staging??
Here's a great paper on pathology if you can get through it!! tinyurl.com/2ac6elj