【正文】 1 Renal Pelvis, Ureter, Bladder and Other Urinary 2 Equivalent Terms, Definitions, Tables and Illustrations 3 Introduction ? Change in groupings –Previous: Kidney, ureter, renal pelvis ? Bladder, ureter, renal pelvis –Lower urinary tract –Lined by transitional epithelium / urothelium 4 Urothelium ? Frequent multiple or multifocal tumors – Field effect: Widespread change in urothelium – Implantation: Cells washed along in urine 5 Flat Carcinoma In Situ ? Direct spread within the epithelium ? Direct extension ? Field effect ? Implantation 6 Squamous Cell Carcinoma Pure squamous cell carcinoma has a poor prognosis See histology coding rules H5 and H13 7 Most Invasive Bladder ? Mucosa ? Lamina propria (some pathologists equate this to submucosa) ? Muscularis mucosae (this layer not always present, may not be mentioned) ? Submucosa ? Muscular layer (muscularis propria, detrusor muscle) ? Serosa, adventitia 8 Most Invasive – Renal Pelvis and Ureter ? Epithelium ? Subepithelial connective tissue, submucosa ? Periureteric fat, peripelvic fat. 9 Multiple Primary Rules 10 Unknown if Single or Multiple Tumors 11 M1 When it is not possible to determine if there is a single tumor or multiple tumors, opt for a single tumor and abstract as a single primary. Note: Use this rule only after all information sources have been exhausted. 12 Single Tumor 13 M2 A single tumor is always a single primary. Note: The tumor may overlap onto or extend into adjacent/contiguous site or subsite. 14 Multiple Tumors 15 M3 When no other urinary sites are involved, tumor(s) in both th