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WHO/ISUP classification


Reviewers: Sean Williamson, M.D. (see Reviewers page)
Revised: 2 June 2012, last major update June 2012
Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.


Flat hyperplasia:
● Markedly thickened mucosa without cytologic atypia
● May be adjacent to low grade papillary urothelial neoplasm
● By itself has no malignant potential and requires no treatment

Papillary hyperplasia:
● Slight tenting, undulating or papillary growth lined by urothelium of varying thickness, without atypia
● Asymptomatic, found on routine follow-up cystoscopy of papillary urothelial neoplasms
● Often has small dilated capillaries at base, but no well defined fibrovascular core
● Lacks discrete papillary fronds associated with papillary neoplasm
Treatment: Follow up if new, unknown if increased risk of papillary neoplasm in patient with prior history of papillary urothelial tumor

Papillary hyperplasia with atypia:
● Architectural pattern of papillary hyperplasia with atypia of overlying urothelium
● 80% male, age range 55 to 92 years
● At diagnosis, 50% associated with flat carcinoma in situ, 30% with dysplasia
● Prognostic implications: usually associated with high grade papillary urothelial carcinoma; also CIS and invasive urothelial carcinoma (Hum Pathol 2002;33:512)

End of Ureters > WHO/ISUP classification > Hyperplasia

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