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Title: |
PUNLMP or Not PUNLMP? This is the Problem | |||||||||||||||||||
| Authors: | Sara Giorgini, M.D., Francesca Barbisan, M.D., Doriana Morichetti, M.D., Roberta Mazzucchelli, M.D., Ph.D., and Daniela Marzioni, Bc.Sc., Ph.D. | |||||||||||||||||||
| To the Editors: Papillary urothelial neoplasm of low malignant potential (PUNLMP) was proposed by the World Health Organization (WHO)/International Society of Urological Pathology (ISUP) in 19981 and adopted by the WHO 2004 system.2 This diagnostic category of noninvasive bladder neoplasms does not carry the label of ìcarcinomaî even if includes many cases that would be categorized as G1 papillary urothelial carcinoma in the WHO 1973 classification.3 The term carcinoma is routinely used to describe noninvasive neoplasms in the bladder. A major criticism of the WHO 1973 classification of urothelial tumors is that low grade and noninvasive tumors with limited biologic aggressiveness are labelled carcinomas, burdening the patient with the psychosocial and financial (insurance) implications that come with a diagnosis of ìcancer.î For this reason, the separate diagnostic category of PUNLMP has been created so that patients with this diagnosis are not subjected to this burden. It is true that the term cancer is avoided, but the term malignancy is introduced and, even if defined as having low potential, may be a cause of greater anxiety than the scientific term carcinoma. | ||||||||||||||||||||
| Keywords: | bladder cancer, bladder neoplasms, papillary urothelial neoplasm of low malignant potential | |||||||||||||||||||
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