Biopsy of one ureter (PG037)

Ureteral biopsy — is the removal of a tissue sample from the wall of the ureter for further histological examination. The procedure is usually performed during ureteroscopy (endoscopic examination of the ureter) when the doctor detects a suspicious area, stricture, or neoplasm. Code PG037 corresponds to the pathological analysis of material taken from a single ureter.

Research objective: The main task is morphological verification of the pathological process. Biopsy allows to distinguish benign changes, such as chronic inflammation (urethritis) or fibrous strictures, from urothelial carcinoma, a malignant tumor of the upper urinary tract.

What does the pathologist evaluate:

• Structure of the urothelium: checking the integrity and structure of the transitional epithelium lining the ureter.

• Presence of atypia: search for cells with signs of malignant degeneration.

• Degree of differentiation (Grade): If a tumor is detected, its aggressiveness is determined (Low grade or High grade).

• Depth of invasion: assessment of whether the tumor has grown into the muscle layer of the ureteral wall.

• Inflammatory changes: diagnosis of nonspecific or specific (e.g., tuberculosis) lesions.

Clinical significance: The results of the study are key to choosing surgical tactics. In benign processes or tumors of low aggressiveness, organ-preserving treatment (endoscopic removal) is possible. In case of confirmation of invasive cancer, radical surgery is usually required - nephroureterectomy (removal of the kidney along with the ureter).

When is it prescribed:

• detection of filling defects or neoplasms in the ureter during CT urography or MRI;

• unexplained narrowing (stricture) of the ureter to exclude a tumoral nature;

• positive result of urine cytology in the absence of a tumor in the bladder;

• macroscopic hematuria (blood in the urine), the source of which is localized in the upper urinary tract.