Papillary urothelial neoplasm of low malignant potential: Difference between revisions
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{{Infobox medical condition | |||
[[File:Punlmp2.jpg| | | name = Papillary urothelial neoplasm of low malignant potential | ||
| image = [[File:Punlmp2.jpg|250px]] | |||
| caption = Histopathological image of papillary urothelial neoplasm of low malignant potential | |||
| field = [[Urology]], [[Oncology]] | |||
| synonyms = PUNLMP | |||
| symptoms = Often asymptomatic, may present with [[hematuria]] | |||
| complications = Rare progression to [[bladder cancer]] | |||
| onset = Typically in [[adulthood]] | |||
| duration = Variable | |||
| types = | |||
| causes = Unknown | |||
| risks = [[Smoking]], [[chemical exposure]], [[chronic bladder irritation]] | |||
| diagnosis = [[Cystoscopy]], [[biopsy]] | |||
| differential = [[Urothelial carcinoma]], [[bladder papilloma]] | |||
| prevention = Avoidance of risk factors | |||
| treatment = [[Transurethral resection]], [[surveillance]] | |||
| medication = | |||
| prognosis = Excellent with treatment | |||
| frequency = Less common than [[urothelial carcinoma]] | |||
}} | |||
'''Papillary urothelial neoplasm of low malignant potential''' (PUNLMP) is a type of [[urothelial neoplasm]] that occurs in the [[urinary bladder]]. It is characterized by its papillary architecture and low potential for progression to invasive cancer. PUNLMP is considered a non-invasive neoplasm and is distinct from [[urothelial carcinoma]] due to its lower risk of recurrence and progression. | '''Papillary urothelial neoplasm of low malignant potential''' (PUNLMP) is a type of [[urothelial neoplasm]] that occurs in the [[urinary bladder]]. It is characterized by its papillary architecture and low potential for progression to invasive cancer. PUNLMP is considered a non-invasive neoplasm and is distinct from [[urothelial carcinoma]] due to its lower risk of recurrence and progression. | ||
== Pathology == | == Pathology == | ||
PUNLMPs are defined by their papillary structures lined by urothelial cells that exhibit minimal cytological atypia. The architecture is typically orderly, with a low degree of cellular proliferation. Unlike [[papillary urothelial carcinoma]], PUNLMPs do not show significant nuclear atypia or mitotic activity. | PUNLMPs are defined by their papillary structures lined by urothelial cells that exhibit minimal cytological atypia. The architecture is typically orderly, with a low degree of cellular proliferation. Unlike [[papillary urothelial carcinoma]], PUNLMPs do not show significant nuclear atypia or mitotic activity. | ||
[[File:Punlmp1.jpg|Histological image of PUNLMP showing papillary structures|left|thumb]] | |||
[[File:Punlmp1.jpg|Histological image of PUNLMP showing papillary structures|thumb | |||
The diagnosis of PUNLMP is primarily based on histological examination of tissue obtained via [[transurethral resection]]. Pathologists look for the presence of papillary fronds with a fibrovascular core and a urothelial lining that lacks the significant atypia seen in higher-grade lesions. | The diagnosis of PUNLMP is primarily based on histological examination of tissue obtained via [[transurethral resection]]. Pathologists look for the presence of papillary fronds with a fibrovascular core and a urothelial lining that lacks the significant atypia seen in higher-grade lesions. | ||
== Clinical Presentation == | == Clinical Presentation == | ||
Patients with PUNLMP often present with [[hematuria]], which is the presence of blood in the urine. This symptom prompts further investigation, typically starting with [[urinalysis]] and [[cystoscopy]]. During cystoscopy, PUNLMPs appear as papillary lesions projecting into the bladder lumen. | Patients with PUNLMP often present with [[hematuria]], which is the presence of blood in the urine. This symptom prompts further investigation, typically starting with [[urinalysis]] and [[cystoscopy]]. During cystoscopy, PUNLMPs appear as papillary lesions projecting into the bladder lumen. | ||
== Management == | == Management == | ||
The management of PUNLMP involves complete resection of the lesion via transurethral resection. Regular follow-up with cystoscopy is recommended due to the potential for recurrence, although the risk of progression to invasive cancer is low. | The management of PUNLMP involves complete resection of the lesion via transurethral resection. Regular follow-up with cystoscopy is recommended due to the potential for recurrence, although the risk of progression to invasive cancer is low. | ||
== Prognosis == | == Prognosis == | ||
The prognosis for patients with PUNLMP is generally favorable. The risk of progression to [[muscle-invasive bladder cancer]] is low, and the overall survival rate is high. However, recurrence can occur, necessitating regular surveillance. | The prognosis for patients with PUNLMP is generally favorable. The risk of progression to [[muscle-invasive bladder cancer]] is low, and the overall survival rate is high. However, recurrence can occur, necessitating regular surveillance. | ||
== Molecular Characteristics == | == Molecular Characteristics == | ||
[[File:Expression_of_p53_in_urothelial_neoplasms.png|Expression of p53 in urothelial neoplasms|left|thumb]] | |||
[[File:Expression_of_p53_in_urothelial_neoplasms.png|Expression of p53 in urothelial neoplasms|thumb | |||
Molecular studies of PUNLMP have shown that these lesions often lack the genetic alterations seen in higher-grade urothelial carcinomas. For example, alterations in the [[TP53]] gene, which are common in high-grade urothelial carcinoma, are typically absent in PUNLMP. | Molecular studies of PUNLMP have shown that these lesions often lack the genetic alterations seen in higher-grade urothelial carcinomas. For example, alterations in the [[TP53]] gene, which are common in high-grade urothelial carcinoma, are typically absent in PUNLMP. | ||
== See also == | |||
== | |||
* [[Urothelial carcinoma]] | * [[Urothelial carcinoma]] | ||
* [[Bladder cancer]] | * [[Bladder cancer]] | ||
* [[Hematuria]] | * [[Hematuria]] | ||
* [[Cystoscopy]] | * [[Cystoscopy]] | ||
[[Category:Urologic neoplasms]] | [[Category:Urologic neoplasms]] | ||
[[Category:Bladder disorders]] | [[Category:Bladder disorders]] | ||
Revision as of 21:20, 8 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Papillary urothelial neoplasm of low malignant potential | |
|---|---|
| |
| Synonyms | PUNLMP |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Often asymptomatic, may present with hematuria |
| Complications | Rare progression to bladder cancer |
| Onset | Typically in adulthood |
| Duration | Variable |
| Types | |
| Causes | Unknown |
| Risks | Smoking, chemical exposure, chronic bladder irritation |
| Diagnosis | Cystoscopy, biopsy |
| Differential diagnosis | Urothelial carcinoma, bladder papilloma |
| Prevention | Avoidance of risk factors |
| Treatment | Transurethral resection, surveillance |
| Medication | |
| Prognosis | Excellent with treatment |
| Frequency | Less common than urothelial carcinoma |
| Deaths | N/A |
Papillary urothelial neoplasm of low malignant potential (PUNLMP) is a type of urothelial neoplasm that occurs in the urinary bladder. It is characterized by its papillary architecture and low potential for progression to invasive cancer. PUNLMP is considered a non-invasive neoplasm and is distinct from urothelial carcinoma due to its lower risk of recurrence and progression.
Pathology
PUNLMPs are defined by their papillary structures lined by urothelial cells that exhibit minimal cytological atypia. The architecture is typically orderly, with a low degree of cellular proliferation. Unlike papillary urothelial carcinoma, PUNLMPs do not show significant nuclear atypia or mitotic activity.
The diagnosis of PUNLMP is primarily based on histological examination of tissue obtained via transurethral resection. Pathologists look for the presence of papillary fronds with a fibrovascular core and a urothelial lining that lacks the significant atypia seen in higher-grade lesions.
Clinical Presentation
Patients with PUNLMP often present with hematuria, which is the presence of blood in the urine. This symptom prompts further investigation, typically starting with urinalysis and cystoscopy. During cystoscopy, PUNLMPs appear as papillary lesions projecting into the bladder lumen.
Management
The management of PUNLMP involves complete resection of the lesion via transurethral resection. Regular follow-up with cystoscopy is recommended due to the potential for recurrence, although the risk of progression to invasive cancer is low.
Prognosis
The prognosis for patients with PUNLMP is generally favorable. The risk of progression to muscle-invasive bladder cancer is low, and the overall survival rate is high. However, recurrence can occur, necessitating regular surveillance.
Molecular Characteristics
Molecular studies of PUNLMP have shown that these lesions often lack the genetic alterations seen in higher-grade urothelial carcinomas. For example, alterations in the TP53 gene, which are common in high-grade urothelial carcinoma, are typically absent in PUNLMP.
