SIU-WJU Article of the Month – April 2019
Biopsy of upper tract urothelial carcinoma
SIU Academy®. Dr. Nikolaos Kostakopoulos and Prof. Athanasios Papatsoris . Apr 1, 2019; 260731 Topic: Biopsy/Pathology
Dr. Nikolaos Kostakopoulos and Prof. Athanasios Papatsoris
  Dr. Nikolaos Kostakopoulos and Prof. Athanasios Papatsoris
Login now to access Regular content available to all registered users.

To have an exclusive access to the entire content available on SIU Academy, become an SIU Member here.

You may also access SIU content "anytime, anywhere" with the FREE SIU ACADEMY App for iOS and Android.
Discussion Forum (0)
Rate & Comment (0)

A correct characterization of upper tract urothelial carcinoma (UTUC) lesions is fundamental to appropriately select patients suitable for endoscopic management. We analyzed the diagnostic yield of three different biopsy tools for the histology evaluation of the UTUC. Furthermore, the concordance between biopsy grading and final UTUC pathology results at specimen (i.e., after ureterectomy or radical nephroureterectomy—RNU) was evaluated.

Materials and methods 

Three different devices were evaluated: 3F biopsy forceps, 6F  BIGopsy® Backloading biopsy forceps and the 2.2F Nitinol Basket. Data were collected between January 2015 and October 2017 and retrospectively analyzed. Univariate and multivariate logistic regression analyses were performed to identify the variables related to diagnosis.


A total of 302 biopsies were taken: lesions could be characterized in 236 (78.2%) specimens by the pathologist. Positive biopsies for UTUC were found in 140 specimens. In 66 biopsies (21.8%), the quality of the tissue sampled was inad-equate for a histological characterization; of these, 55 (83.3%) were taken using 3F forceps and 11 (16.7%) using BIGopsy forceps. No inadequate specimen arose using the 2.2F Nitinol Basket. Among 28 patients who underwent distal ureterectomy or RNU, the tumor was upgraded to high grade in 9 (32%), while in 19 (68%) the grading was confirmed.


In comparison to 3F forceps, the BIGopsy forceps showed to be more accurate in obtaining sufficient speci-men for pathologic examination. In papillary lesions, the 2.2F Nitinol basket achieves a final histology characterization in 100% of the cases. For tumor < 2 cm, there is a high concordance between URS biopsy grade and final pathology (distal ureterectomy or RNU).


Biopsy · Flexible ureteroscopy · Nephro-sparing surgery · Upper tract urothelial carcinoma
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.

Save Settings