Severe atypia of transitional epithelium and carcinoma of the urinary bladder

Abstract

Forty-nine cystectomy specimens obtained between 1969 and 1971, during treatment of cancer of the urinary bladder, were reviewed along with the clinical records from this group of patients. The occurrence of severe atypia of the transitional epithelium in the bladder, ureters, and urethra was correlated with morphological and clinical features of the tumors. Severe atypia of the transitional epithelium was most often found adjacent to a tumor and was frequently seen in the bladder remote from a tumor. It was not infrequently noted in the urethra and ureters. The atypia was most commonly associated with carcinomas composed of poorly differentiated transitional cells. It was not related to the stage or configuration of the tumor. A correlation with age, smoking history, or preoperative therapeutic regimen was not demonstrated. The lesion was more prevalent in males. Whether severe epithelial atypia represents an in-situ stage of carcinoma, a precursor of carcinoma, or a concomitant finding is not proven, although there is increasing evidence that it may precede anaplastic carcinoma in the lower urinary tract.