Urinary bladder

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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

AKA cut-up.

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

General

  • Strong association with Schistosoma haematobium.[2]
    • Common in areas with S. haematobium.
    • Uncommon in areas without S. haematobium.

Microscopic

Features:

Urachal carcinoma

Urinary bladder infarct

General

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

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

  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. 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. 4.0 4.1 4.2 Nino-Murcia, M.; Friedland, GW. (1988). "Bladder infarct.". Urol Radiol 9 (4): 234-6. PMID 3394185.
  5. 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.