Difference between revisions of "Urinary bladder"

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Urinary bladder (view source)

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The '''urinary bladder''' stores urine until one has to go wee-wee.
The '''urinary bladder''' stores urine between urination, i.e. trips to the washroom to go pee. It gets the urine from the [[ureter]]s and exspells it via the [[urethra]].


It is commonly afflicted by cancer.
It is commonly afflicted by [[cancer]]. A well-know mimicker of cancer is ''[[malakoplakia]]''.<ref name=pmid17102055>{{cite journal |author=Wong-You-Cheong JJ, Woodward PJ, Manning MA, Davis CJ |title=From the archives of the AFIP: Inflammatory and nonneoplastic bladder masses: radiologic-pathologic correlation |journal=Radiographics |volume=26 |issue=6 |pages=1847–68 |year=2006 |pmid=17102055 |doi=10.1148/rg.266065126 |url=}}</ref>


A well-know mimicker of cancer is ''[[malakoplakia]]''.<ref name=pmid17102055>{{cite journal |author=Wong-You-Cheong JJ, Woodward PJ, Manning MA, Davis CJ |title=From the archives of the AFIP: Inflammatory and nonneoplastic bladder masses: radiologic-pathologic correlation |journal=Radiographics |volume=26 |issue=6 |pages=1847–68 |year=2006 |pmid=17102055 |doi=10.1148/rg.266065126 |url=}}</ref>
=Normal=
 
==Normal==
===Microscopic===
===Microscopic===
*Muscularis mucosae - thin, discontinuous.
*Muscularis mucosae - thin, discontinuous.
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Note:
Note:
*On TURBT - don't ever call T3.
*On TURBT - don't ever call pT3.


==Urinary bladder cancer==
=Grossing=
The most common type of cancer to affect the bladder is ''urothelial carcinoma'', which is covered in the ''[[urothelium]]'' article.
:[[AKA]] ''cut-up''.
{{Main|Partial cystectomy}}
{{Main|Radical cystectomy}}
{{Main|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'':
*[[Schistosoma haematobium|'''S'''chistomsoma haematobium]] - esp. squamous cell carcinoma.<ref name=pmid17483025/>
*'''EX'''trophy of the bladder.
*'''L'''ithiasis.
*'''I'''ndwelling catheter ''or'' chronic '''I'''nflammation.<ref name=pmid17483025>{{Cite journal  | last1 = Michaud | first1 = DS. | title = Chronic inflammation and bladder cancer. | journal = Urol Oncol | volume = 25 | issue = 3 | pages = 260-8 | month =  | year =  | doi = 10.1016/j.urolonc.2006.10.002 | PMID = 17483025 }}</ref>
*'''C'''yclophosphamide.  


DDx:
DDx:
*[[Urothelial carcinoma]].
*[[Urothelial carcinoma]] - most common in the Western world.
*[[Squamous cell carcinoma of the urinary bladder]].
*[[Squamous cell carcinoma of the urinary bladder]] - most common in areas with ''Schistosoma''.
*Adenocarcinoma - see ''[[urachal carcinoma]]''.
*Adenocarcinoma.
**[[Urachal adenocarcinoma]].
**[[Primary adenocarcinoma of the urinary bladder]].
**Metastatic adenocarcinoma - usu. [[colorectal adenocarcinoma]].
*Other tumours - rare.
**Rhabdomyosarcomatous tumour.
**[[Rhabdomyosarcoma]].<ref name=pmid21762516>{{Cite journal  | last1 = Bing | first1 = Z. | last2 = Zhang | first2 = PJ. | title = Adult urinary bladder tumors with rhabdomyosarcomatous differentiation: clinical, pathological and immunohistochemical studies. | journal = Diagn Pathol | volume = 6 | issue =  | pages = 66 | month =  | year = 2011 | doi = 10.1186/1746-1596-6-66 | PMID = 21762516 }}</ref>
 
==Squamous cell carcinoma of the urinary bladder==
{{Main|Squamous cell carcinoma of the urinary bladder}}
*Rare type of bladder cancer.
*''Urothelial carcinoma with squamous differentiation'' is much more common.


==Urachal carcinoma==
==Urachal carcinoma==
{{Main|Urachal carcinoma}}
==Rhabdomyosarcoma of the urinary bladder==
{{Main|Rhabdomyosarcoma}}
===General===
===General===
*Rare.<ref name=pmid16826585>{{Cite journal  | last1 = Ashley | first1 = RA. | last2 = Inman | first2 = BA. | last3 = Sebo | first3 = TJ. | last4 = Leibovich | first4 = BC. | last5 = Blute | first5 = ML. | last6 = Kwon | first6 = ED. | last7 = Zincke | first7 = H. | title = Urachal carcinoma: clinicopathologic features and long-term outcomes of an aggressive malignancy. | journal = Cancer | volume = 107 | issue = 4 | pages = 712-20 | month = Aug | year = 2006 | doi = 10.1002/cncr.22060 | PMID = 16826585 }}</ref>
*Considered extremely rare in adults.<ref name=pmid21762516>{{Cite journal  | last1 = Bing | first1 = Z. | last2 = Zhang | first2 = PJ. | title = Adult urinary bladder tumors with rhabdomyosarcomatous differentiation: clinical, pathological and immunohistochemical studies. | journal = Diagn Pathol | volume = 6 | issue = | pages = 66 | month = | year = 2011 | doi = 10.1186/1746-1596-6-66 | PMID = 21762516 }}</ref>
*Classically - dome of bladder lesion.
*Younger <55 years-old.


===Microscopic===
===Microscopic===
====Patterns====
:See ''[[rhabdomyosarcoma]]''.
*Enteric - looks like colonic adenocarcinoma.
*Mucinous.
*Signet ring.


DDx:
DDx:
*Metastatic adenocarcinoma/adenocarcinoma extending from another structure.
*Rhabdomyosarcomatous sarcomatoid carcinoma - more common than RMS in adults.
*Adenocarcinoma arising from the urinary bladder.
**Requires the identification of a carcinoma component.
*Rhabdomyomatous tumour.<ref name=pmid21762516>{{Cite journal  | last1 = Bing | first1 = Z. | last2 = Zhang | first2 = PJ. | title = Adult urinary bladder tumors with rhabdomyosarcomatous differentiation: clinical, pathological and immunohistochemical studies. | journal = Diagn Pathol | volume = 6 | issue =  | pages = 66 | month =  | year = 2011 | doi = 10.1186/1746-1596-6-66 | PMID = 21762516 }}</ref>
**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:<ref name=pmid21762516>{{Cite journal  | last1 = Bing | first1 = Z. | last2 = Zhang | first2 = PJ. | title = Adult urinary bladder tumors with rhabdomyosarcomatous differentiation: clinical, pathological and immunohistochemical studies. | journal = Diagn Pathol | volume = 6 | issue =  | pages = 66 | month =  | year = 2011 | doi = 10.1186/1746-1596-6-66 | PMID = 21762516 }}</ref>
*Desmin +ve.
*Myogenin +ve.
*Keratins -ve.
 
==Metastasis to the urinary bladder==
{{Main|Urinary bladder metastasis}}
 
=Other=
==Urinary bladder infarct==
{{Main|Infarction}}
===General===
*Case report rare - as the organ has many colaterals.<ref name=pmid3394185>{{Cite journal  | last1 = Nino-Murcia | first1 = M. | last2 = Friedland | first2 = GW. | title = Bladder infarct. | journal = Urol Radiol | volume = 9 | issue = 4 | pages = 234-6 | month =  | year = 1988 | doi =  | PMID = 3394185 }}</ref>
*May be seen in association with [[pseudocarcinomatous urothelial hyperplasia]].<ref name=pmid23228381>{{Cite journal  | last1 = Kryvenko | first1 = ON. | last2 = Epstein | first2 = JI. | title = Pseudocarcinomatous urothelial hyperplasia of the bladder: clinical findings and followup of 70 patients. | journal = J Urol | volume = 189 | issue = 6 | pages = 2083-6 | month = Jun | year = 2013 | doi = 10.1016/j.juro.2012.12.005 | PMID = 23228381 }}</ref>
 
===Microscopic===
Features:<ref name=pmid3394185/>
*[[Necrosis]] without liquefaction.
**Outlines of cells visible.
**No nuclei present.
 
Note:
*Liquefaction implies an infectious etiology.<ref name=pmid3394185/>
 
==Urinary bladder amyloidosis==
{{Main|Urinary bladder amyloidosis}}
 
==Tubular adenoma of the urinary bladder==
{{Main|Tubular adenoma of the urinary tract}}
 
==Keratinising squamous metaplasia of the urinary bladder==
{{Main|Keratinising squamous metaplasia of the urinary bladder}}
 
==Leiomyoma of the urinary bladder==
{{Main|Leiomyoma of the urinary bladder}}


Images:
==Cystitis==
*[http://commons.wikimedia.org/wiki/File:Urachal_carcinoma_-_low_mag.jpg UC - low mag. (WC)].
:See ''[[urothelium]]''.
*[http://commons.wikimedia.org/wiki/File:Urachal_carcinoma_-_high_mag.jpg UC - high mag. (WC)].


==See also==
=See also=
*[[Genitourinary pathology]].
*[[Genitourinary pathology]].
*[[Urothelium]].


==References==
=References=
{{Reflist|1}}
{{Reflist|1}}


[[Category:Genitourinary pathology]]
[[Category:Genitourinary pathology]]
[[Category:Urinary bladder]]
Michael
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