Scanning electron microscopy in early human bladder neoplasia

Biopsies of healthy looking urothelium from 61 patients with transitional cell carcinoma (TCC) of bladder were examined by scanning electron microscopy (SEM) and light microscopy. A proportion (40%) showed abnormal features on SEM, in particular pleomorphic microvilli (PMV) in at least one area. SEM appearances were graded into four categories depending upon divergence from normal. Patients were followed up at cystoscopy and one year later a strong correlation was noted between original abnormal SEM appearances and subsequent tumour recurrence. These early results suggest that SEM could be helpful in the diagnosis, assessment, and clinical management of the unstable urothelium.