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

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.