Difference between revisions of "Urinary bladder"
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Revision as of 14:48, 13 February 2015
The urinary bladder stores urine until one has to go pee. It gets the urine from the ureters and exspells it via the urethra.
It is commonly afflicted by cancer. A well-know mimicker of cancer is malakoplakia.[1]
Normal
Microscopic
- Muscularis mucosae - thin, discontinuous.
- Fat - many be in lamina propria.
Note:
- On TURBT - don't ever call pT3.
Grossing
Main article: Partial cystectomy
Main article: Radical cystectomy
Main article: Cystoprostatectomy
Urinary bladder cancer
The most common type of cancer to affect the bladder is urothelial carcinoma. This is covered in the urothelium article.
Risk factors for bladder cancer SEX LIC:
- Schistomsoma haematobium - esp. squamous cell carcinoma.[2]
- EXtrophy of the bladder.
- Lithiasis.
- Indwelling catheter or chronic Inflammation.[2]
- Cyclophosphamide.
DDx:
- Urothelial carcinoma - most common in the Western world.
- Squamous cell carcinoma of the urinary bladder - most common in areas with Schistosoma.
- Adenocarcinoma.
- Urachal adenocarcinoma.
- Primary adenocarcinoma of the urinary bladder.
- Metastatic adenocarcinoma - usu. colorectal adenocarcinoma.
- Other tumours - rare.
- Rhabdomyosarcomatous tumour.
- Rhabdomyosarcoma.[3]
Squamous cell carcinoma of the urinary bladder
Main article: Squamous cell carcinoma
General
- Strong association with Schistosoma haematobium.[2]
- Common in areas with S. haematobium.
- Uncommon in areas without S. haematobium.
Microscopic
Features:
- See squamous cell carcinoma article.
Urachal carcinoma
Main article: Urachal carcinoma
Urinary bladder infarct
Main article: Infarction
General
- Case report rare - as the organ has many colaterals.[4]
- May be seen in association with pseudocarcinomatous urothelial hyperplasia.[5]
Microscopic
Features:[4]
- Necrosis without liquefaction.
- Outlines of cells visible.
- No nuclei present.
Note:
- Liquefaction implies an infectious etiology.[4]
Rhabdomyosarcoma of the urinary bladder
Main article: Rhabdomyosarcoma
General
- Considered extremely rare in adults.[3]
Microscopic
- See rhabdomyosarcoma.
DDx:
- Rhabdomyosarcomatous sarcomatoid carcinoma - more common than RMS in adults.
- Requires the identification of a carcinoma component.
- Rhabdomyomatous tumour.[3]
- Used if no carcinomatous component is identified with extensive sampling.
- Small cell carcinoma of the urinary bladder.
- Should be positive for keratins and chromogranin A.
IHC
Features:[3]
- Desmin +ve.
- Myogenin +ve.
- Keratins -ve.
See also
References
- ↑ Wong-You-Cheong JJ, Woodward PJ, Manning MA, Davis CJ (2006). "From the archives of the AFIP: Inflammatory and nonneoplastic bladder masses: radiologic-pathologic correlation". Radiographics 26 (6): 1847–68. doi:10.1148/rg.266065126. PMID 17102055.
- ↑ 2.0 2.1 2.2 Michaud, DS.. "Chronic inflammation and bladder cancer.". Urol Oncol 25 (3): 260-8. doi:10.1016/j.urolonc.2006.10.002. PMID 17483025.
- ↑ 3.0 3.1 3.2 3.3 Bing, Z.; Zhang, PJ. (2011). "Adult urinary bladder tumors with rhabdomyosarcomatous differentiation: clinical, pathological and immunohistochemical studies.". Diagn Pathol 6: 66. doi:10.1186/1746-1596-6-66. PMID 21762516.
- ↑ 4.0 4.1 4.2 Nino-Murcia, M.; Friedland, GW. (1988). "Bladder infarct.". Urol Radiol 9 (4): 234-6. PMID 3394185.
- ↑ Kryvenko, ON.; Epstein, JI. (Jun 2013). "Pseudocarcinomatous urothelial hyperplasia of the bladder: clinical findings and followup of 70 patients.". J Urol 189 (6): 2083-6. doi:10.1016/j.juro.2012.12.005. PMID 23228381.