A morphometric study on the ultrastructure of well-differentiated tumours and inflammatory mucosa of the human urinary bladder.

Transmission (TEM) and scanning electron microscopic (SEM) observations were performed on well-differentiated tumours and chronic cystitis in the human urinary bladder. SEM showed that the pleomorphic microvilli were present not only on the luminal surface of the tumour but also on the surface of inflammatory mucosa. The ultrastructure of six tumours and 5 cases of chronic cystitis was evaluated morphometrically. Bladder tumour and inflammatory mucosa were divided into several layers, namely outermost cells (S), subsurface cells just beneath these (S1), subsurface cells of 2 or 3 layers below (S23), intermediate cells of 2 or 3 layers above the basal cells (I23), intermediate cells just above the basal cells (I1) and basal cells (Ba). Areas of nucleus, cytoplasm and cytoplasmic organelles, numbers of nucleoli, nuclear bodies, mitochondria and lysosomes together with irregularity of the cell and nucleus were estimated according to the methods of Weibel. A multivariate analysis of variance on these variables showed that the above subdivision of layers was necessary for the comparison of tumour and inflammation. Discriminant analysis showed various differences between tumour and inflammatory mucosa. The results indicated that the Ba layer is the most effective site for differentiating the tumour from inflammation. Ba cells with large and irregular cytoplasm with an enlarged Golgi area, accompanied by many vacuolar structures, may be indicative of tumour rather than inflammation.