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Carcinoma in Situ (CIS) of the urinary bladder can be confused by the histopathologist for reactive atypia in some cases and vise versa. Since making this diagnosis is of paramount importance, unequivocal diagnosis is not helpful. The recent advances made in Immunohistochmistry can help in solving this problem. An immnunostaining panel consisting of cytokeratin 20 and P53 can help in differentiating CIS from other reactive atypical lesions

Usual immnunostaining pattern in the urothelium in benign and reactive atypical lesions is one of characteristic pattern. The positive cytoplasmic staining for cytokeratin 20 on the superficial umbrella layer, and negative nuclear staining for P53 in all the layers is the usual pattern. In CIS , cytokeratin 20 positive cytoplasmic immunostaining is present in all the epithelial layers, and p53 nuclear stain is positive in all the cell layers nuclei

This panel is particularly useful in cases in which the pathologist strongly favors the diagnosis of CIS but has reservation making a definite diagnosis, in diagnosing CIS at initial presentation with no known history of a papillary lesion, or in confirming unusual morphologic presentation of CIS such as cancerization of the urothelium

Please do not hesitate to contact us regarding all cases of CIS, inflammatory atypia and dysplasia diagnosis

We in the First Medical Lab are dedicated to bring the best of Laboratory medicine to clinical practice in Jordan

Dr. Hussam Abu-Farsakh

American Board of Anatomic & Clinical Pathology, and Cytopathology

Circular: is a periodic circular that distributed to clinician informing them about new and important tests available at First Medical Laboratory. All information listed are supported by recent literature