This is a well illustrated review article on uroepithelial dysplasia. In 6 figures, the morphology of the lesions at different stages are demonstrated. Two stages of uroepithelial dysplasias are distinguished: the mild-moderate lesions and the severe form. In the mild-moderate form, the epithelial layers are increased in number with irregularities and crowding of the cell nuclei. In the severe form, the cellular changes are similar to those of carcinoma in situ but do not involve the whole thickness of the epithelium. They should be taken as neoplastic. The changes in human bladders are compared with those in experimental animals induced by large doses of carcinogen. In animals, dysplasias are the first step in carcinogenesis. However, there is no strong evidence for malignant transformation of mild-moderate dysplasias in man. The two theories of the development of dysplasias are discussed. One considers dysplasias as embryonic in origin, the second theory considers dysplasias as reactive changes to environmental factors. The biological significance of uorepithelial dysplasias has not yet been determined; however, it is to be noted that many patients with mild-moderate dysplasia also have bladder cancer. For patients with uroepithelial dysplasia without cancer, the least agressive method of followup is as follows: the urinary cytology should be carried out perhaps at yearly intervals. Invasive diagnostic procedures should follow only definite cytological findings. (Romhanyi, Pecs).
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