COMPARISON BETWEEN THE GROSS APPEARANCE OF HUMAN BLADDER TUMOR AND THE SURFACE FEATURES BY SCANNING ELECTRON MICROSCOPY

Abstract

The usefulness of Matsumoto's endoscopic classification of urinary bladder tumor was evaluated to compare with cellular gradings, cellular thickness, cell surface appearance by scanning electron microscopy (SEM) and clinical course. Bladder tumors from 35 patients (26 men and 9 women) were examined. They were divided into 14 cases of bush type, 16 cases of grapes type and 5 cases of knoll type, according to Matsumoto's endoscopic classification (Proc. of Ann. Meeting of Jpn. Urol. Ass., 1983, p. 61). Bush type consisted of 43 percents of grade 1, 57 percents of grade 2 and none of grade 3. Grapes type consisted of 25 percents of grade 1, 63 percents of grade 2 and 13 percents of grade 3. Knoll type was all grade 3. No significant difference between bush and grapes types was found in thickness of tumor cell layer, but for knoll type the thickness could not be measured because of cellular disorder. Surface features of superficial tumor cells in bush and grapes types by SEM (Jpn. J. Urol., 73; 469, 1982) showed pleomorphic microvilli but the plemorphism of grapes type was higher than that of bush type. Knoll type showed smooth or rough surface. Bush and grapes types showed no difference of tumor recurrence, but some cases of grapes types became invasive. Eighty percents of knoll type was invasive and all of knoll type underwent total cystectomy. It is concluded that cellular gradings, cellular thickness and cell surface appearance by SEM had relatively good corellation with Matsumoto's endoscopic classification. However, these studies suggest that further examination of this problem must be done.