Evidence map›Paper›PMID 33887303›Full record

ArticleHuman pathology2021

Noninvasive low-grade papillary urothelial carcinoma with degenerative nuclear atypia: a grading pitfall.

Andres Matoso, Vamsi Parimi, Jonathan I Epstein

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Human pathology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Andres MatosoDepartment of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231, USA; Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231, USA; Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231, USA; Johns Hopkins Greenberg Bladder Cancer Institute, Baltimore, MD, 21231, USA.
Vamsi ParimiDepartment of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231, USA.
Jonathan I EpsteinDepartment of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231, USA; Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231, USA; Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, 21231, USA; Johns Hopkins Greenberg Bladder Cancer Institute, Baltimore, MD, 21231, USA. Electronic address: jepstein@jhmi.edu.

Funding

Opportunities for Pathology Trainees in Cancer ResearchT32CA193145 · NCI · JOHNS HOPKINS UNIVERSITY · PI ANDERS, ROBERT A., EBERHART, CHARLES G · 2015 to 2025
$2.6M
NCI NIH HHS T32 CA193145
6 · The paper itself

Abstract

Noninvasive low-grade papillary urothelial carcinoma is a papillary neoplasm with orderly appearance and mild nuclear pleomorphism. Some cases show significant nuclear pleomorphism with degenerative atypia leading to grading difficulties. A retrospective review of the pathology files identified 16 cases diagnosed as noninvasive low-grade papillary urothelial carcinoma with degenerative atypia. Fifteen cases were consults. The average age was 46 years (range 19-78). The average size was 1.7 cm (range: 0.3-3.5). The submitting diagnoses in consults were noninvasive high-grade papillary urothelial carcinoma (n = 6), condyloma (n = 1), atypical papillary lesion (n = 1), prominent umbrella cells (n = 1), and not given (n = 6). Ki-67 proliferation rate was <5% in 10 of 10 cases (100%), and the cells with large atypical nuclei were negative. Microscopically, there were scattered cells with nuclei larger than 5 times the size of stromal lymphocytes but displayed smudgy chromatin and occasional multinucleation and intranuclear vacuoles. Next-generation sequencing identified the following mutations: HRAS (n = 4), FGFR3 (n = 3), KRAS (n = 3), BRAF (n = 1), PDGFRA (n = 1), and PIK3CA (n = 1). Other deleterious mutations were identified, but none in genes characteristic of high-grade tumors. Follow-up was available in 6 patients (median 32 months). One patient recurred with a noninvasive low-grade papillary urothelial carcinoma 20 months after the index case. All the remaining patients had no evidence of disease at the last follow-up. No patient died or had disease progression. The combination of preservation of polarity, low mitotic activity, Ki-67 <5% with the larger atypical nuclei negative for Ki-67, along with nuclear atypia that is degenerative are features used to classify these tumors as low grade.

Indexed as

AdultAgedBiomarkers, TumorCarcinoma, PapillaryCell NucleusCell ProliferationDNA Mutational AnalysisFemaleHumansImmunohistochemistryKi-67 AntigenMaleMiddle AgedMitotic IndexMutationNeoplasm GradingBiomarkers, TumorKi-67 AntigenMKI67 protein, humanBladder cancerDegenerative atypiaGradeKi67Papillary urothelial carcinoma

Identifiers

PMID33887303
PMCPMC9281537

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.