Interpretation of bladder specimens can be challenging, especially in the context of numerous variants of bladder cancer, associated mimickers, new staging criteria and rapidly evolving ancillary techniques. The aim of this course is to provide a systematic, algorithmic approach to the diagnosis of bladder carcinoma, including ancillary techniques when appropriate, as well as to provide a detailed overview of mesenchymal lesions that can occur in this location. Both general and academic pathologists, as well as pathologists-in-training, would benefit from this session.

This course will combine didactic and case-based presentations that will include review of morphologic features important in the distinction between non-invasive and invasive carcinoma, identification of bladder cancer variants, evaluation of invasive depth, and impact of prostatic involvement in staging. Re-evaluation of key factors in bladder cancer diagnosis and staging will be discussed in light of the new AJCC criteria. In addition, mesenchymal lesions, which often present a challenging differential diagnosis in bladder specimens, will be covered in detail. Incorporation of ancillary techniques, including immunohistochemistry, special stains and fluorescent in situ hybridization (FISH), will be included when relevant. Emphasis will be placed on delineating a step-wise, algorithmic approach to bladder specimens and differential diagnoses.

Upon completion of this course, participants should be able to: 1) recognize the distinction between various forms of non-invasive and invasive bladder lesions, 2) correctly stage invasive bladder carcinomas according to new guidelines, 3) identify mimickers of bladder neoplasia, and 4) make judicious use of ancillary techniques in the evaluation of bladder specimens.

Pre-course material will include a study set of 10 online cases posted at the USCAP website. A course syllabus will be distributed during the session. After the USCAP meeting, participants will be able to access the course presentation, additional representative histopathologic images of entities discussed, and a complete reference list on the USCAP website.

(NEW COURSE) This course may be used for CME credits or SAM credits.