Difference between revisions of "Urinary bladder"

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==Urachal carcinoma==
==Urachal carcinoma==
===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>
*Very 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>~ 0.2% of bladder cancers.<ref name=pmid22901574>{{Cite journal  | last1 = Bruins | first1 = HM. | last2 = Visser | first2 = O. | last3 = Ploeg | first3 = M. | last4 = Hulsbergen-van de Kaa | first4 = CA. | last5 = Kiemeney | first5 = LA. | last6 = Witjes | first6 = JA. | title = The clinical epidemiology of urachal carcinoma: results of a large, population based study. | journal = J Urol | volume = 188 | issue = 4 | pages = 1102-7 | month = Oct | year = 2012 | doi = 10.1016/j.juro.2012.06.020 | PMID = 22901574 }}</ref>
*Classically - dome of bladder lesion.
*Younger <55 years-old.
*Younger <55 years-old.
===Gross===
*Lesion must be in urachus or dome of urinary bladder.


===Microscopic===
===Microscopic===
Features:
*Usually adenocarcinoma.
*Adjacent urothelium typically benign.
DDx:<ref>{{Ref Amin|2-143}}</ref>
*[[Adenocarcinoma of the urinary bladder]].
*Invasive [[urothelial carcinoma]] with glandular differentiation.
*Metastatic adenocarcinoma/adenocarcinoma extending from another structure, e.g. [[colorectal adenocarcinoma]].
====Patterns====
====Patterns====
*Enteric - looks like colonic adenocarcinoma.
*Enteric - looks like colonic adenocarcinoma.
*Mucinous.
*Mucinous.
*Signet ring.
*Signet ring.
DDx:
*[[Adenocarcinoma of the urinary bladder]].
*Invasive [[urothelial carcinoma]] with glandular differentiation.
*Metastatic adenocarcinoma/adenocarcinoma extending from another structure, e.g. [[colorectal adenocarcinoma]].


====Images====
====Images====

Revision as of 20:29, 4 December 2013

The urinary bladder stores urine until one has to go wee-wee.

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 T3.

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:

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:

Urachal carcinoma

General

  • Very rare[3]~ 0.2% of bladder cancers.[4]
  • Younger <55 years-old.

Gross

  • Lesion must be in urachus or dome of urinary bladder.

Microscopic

Features:

  • Usually adenocarcinoma.
  • Adjacent urothelium typically benign.

DDx:[5]

Patterns

  • Enteric - looks like colonic adenocarcinoma.
  • Mucinous.
  • Signet ring.

Images

  • UC - very low mag. (WC)

  • UC - low mag. (WC)

  • UC - high mag. (WC)

IHC

Features:[6]

  • CK20 +ve.
  • CK7 +ve/-ve.
  • CK34betaE12 +ve/-ve.
  • Beta-catenin -- usu cytoplasmic/membranous +ve.

Others:[7]

  • p63 -ve (+ve in only 3%).

UC versus CRC -- not absolute but useful:

  • CK34betaE12 +ve in UC (-ve in CRC).
  • Beta-catenin -ve nuclei in UC (+ve nuclei in CRC).

Urinary bladder infarct

Main article: Infarction

General

Microscopic

Features:[8]

  • Necrosis without liquefaction.
    • Outlines of cells visible.
    • No nuclei present.

Note:

  • Liquefaction implies an infectious etiology.[8]

Rhabdomyosarcoma

Main article: Rhabdomyosarcoma

See also

References

  1. ↑ 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. ↑ 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. ↑ Ashley, RA.; Inman, BA.; Sebo, TJ.; Leibovich, BC.; Blute, ML.; Kwon, ED.; Zincke, H. (Aug 2006). "Urachal carcinoma: clinicopathologic features and long-term outcomes of an aggressive malignancy.". Cancer 107 (4): 712-20. doi:10.1002/cncr.22060. PMID 16826585.
  4. ↑ Bruins, HM.; Visser, O.; Ploeg, M.; Hulsbergen-van de Kaa, CA.; Kiemeney, LA.; Witjes, JA. (Oct 2012). "The clinical epidemiology of urachal carcinoma: results of a large, population based study.". J Urol 188 (4): 1102-7. doi:10.1016/j.juro.2012.06.020. PMID 22901574.
  5. ↑ Amin, Mahul B. (2010). Diagnostic Pathology: Genitourinary (1st ed.). Amirsys. pp. 2-143. ISBN 978-1931884280.
  6. ↑ Gopalan, A.; Sharp, DS.; Fine, SW.; Tickoo, SK.; Herr, HW.; Reuter, VE.; Olgac, S. (May 2009). "Urachal carcinoma: a clinicopathologic analysis of 24 cases with outcome correlation.". Am J Surg Pathol 33 (5): 659-68. doi:10.1097/PAS.0b013e31819aa4ae. PMID 19252435.
  7. ↑ Paner, GP.; McKenney, JK.; Barkan, GA.; Yao, JL.; Frankel, WL.; Sebo, TJ.; Shen, SS.; Jimenez, RE. (Jun 2011). "Immunohistochemical analysis in a morphologic spectrum of urachal epithelial neoplasms: diagnostic implications and pitfalls.". Am J Surg Pathol 35 (6): 787-98. doi:10.1097/PAS.0b013e3182189c11. PMID 21572312.
  8. ↑ 8.0 8.1 8.2 Nino-Murcia, M.; Friedland, GW. (1988). "Bladder infarct.". Urol Radiol 9 (4): 234-6. PMID 3394185.
  9. ↑ 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.
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