Micrograph of a PUNLMP showing characteristic features (see text). H&E stain. PUNLMPs are exophytic lesions that appear friable to the naked eye and when imaged during cystoscopy. They are definitively diagnosed after removal by microscopic examination by pathologists. Histologically, they have a<unk>  architecture with slender fibro vascular cores and rare basal mitoses. The papillae rarely fuse and uncommonly branch. Cytologically, they have uniform nuclear enlargement. They cannot be reliably differentiated from<unk>  grade<unk>  urothelial carcinomas using cytology, and their diagnosis (vis-a-vis<unk>  grade<unk>  urothelial carcinoma) has a poor inter-rater reliability. Pathologic grading and staging tumors are: graded by the degree of cellular atypia (G1->G3), and staged: * papilloma *<unk>  tumor of<unk><unk>  potential (PTLMP) *<unk>  urothelial carcinomas<unk>  grade *<unk>  urothelial carcinomas high grade. Differential diagnosis * Papilloma. *<unk>  grade<unk>  urothelial carcinoma.
Papillary urothelial neoplasm of low malignant potential
Prostatic stromal tumour of uncertain malignant potential
Smooth muscle tumor of uncertain malignant potential
Invasive urothelial carcinoma
Germ cell neoplasia in situ
Intranodal palisaded myofibroblastoma
Villoglandular adenocarcinoma of the cervix
Mammary-type myofibroblastoma