Urothelial dysplasia of the bladder: Diagnostic features and clinical significance

Antonio Lopez-Beltran, Rodolfo Montironi, Alfredo Vidal, Marina Scarpelli, Liang Cheng

Research output: Contribution to journalArticle

15 Scopus citations


The 2004 World Health Organization classification system for urothelial neoplasia identifies urothelial dysplasia (low-grade intraurothelial neoplasia) as a premalignant lesion of the urothelium. Although diagnostic criteria of urothelial dysplasia have been improved in recent years, there is a frequent lack of interobserver reproducibility. Follow-up studies suggest that dysplasia is a marker for urothelial instability and disease progression in up to 19% of patients, thus supporting an active clinical follow-up in these patients. The main differential diagnosis of urothelial dysplasia includes flat urothelial lesions with atypia, mainly flat (simple) urothelial hyperplasia, reactive urothelial atypia, urothelial atypia of unknown significance, and urothelial carcinoma in situ (high-grade intraurothelial neoplasia). In most cases, morphologic features alone suffice for diagnosis. Some cases may require a panel of immunohistochemical antibodies consisting of cytokeratin 20, p53 and CD44 for diagnosis. We present pathologic features and clinical significance of urothelial dysplasia with emphasis on differential diagnosis from common flat urothelial lesions with atypia. (Anal Quant Cytopathol Histopathol 2013;35:121-129).

Original languageEnglish (US)
Pages (from-to)121-129
Number of pages9
JournalAnalytical and Quantitative Cytology and Histology
Issue number3
StatePublished - Jun 2013


  • Carcinoma in situ
  • Diagnosis
  • Intraepithelial neoplasms
  • Pathology
  • Urothelial dysplasia
  • Urothelium

ASJC Scopus subject areas

  • Anatomy
  • Histology

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