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, logical approach to the diagnosis of bladder carcinoma, incorporating ancillary techniques and treatment outcomes, when appropriate. 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. Case-based presentations will be facilitated by the use of an audience response system. Re-evaluation of key factors in bladder cancer diagnosis and staging will be discussed in light of the new 2009 AJCC criteria. Incorporation of ancillary techniques, including immunohistochemistry, special stains and fluorescent in situ hybridization (FISH), will be included in the context of both surgical pathology and cytopathology specimens. Emphasis will be placed on the identification of histopathologic factors that ultimately impact clinical care and patient outcomes.

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 12 virtual slides posted online at the USCAP website. A course syllabus will be distributed during the session. After the USCAP meeting, participants will receive a CD containing the course presentation, additional representative histopathologic images of entities discussed, and a complete reference list. (New Course) This course may be used for CME credits or SAM’s credits.