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Urinary System
Published in Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard, Toxicologic Pathology, 2018
Kendall S. Frazier, John Curtis Seely
Urothelial carcinomas are rarely reported as spontaneous tumors but have been induced (Hard 1990). Usually, carcinomas are solitary tumors which may become large and are poorly demarcated. They tend to be invasive with well-differentiated to anaplastic cellular morphology. The growth pattern may be papillary to solid with a broad base. Highly malignant tumors have considerable cytoplasmic and nuclear anaplastic features. Mitoses are variable with some abnormal forms. Stoma is sparse. Both squamous or glandular metaplasia may be observed. Metastases have been reported (Frith 1998; Frith et al. 1995; Pauli et al. 1998). Spindle cell or undifferentiated carcinomas are positive for cytokeratin (Sykes and Stula 1998). Uroplakins, transmembrane proteins found in umbrella cells, have proved useful as a marker in detecting urothelial lineage in tumors (Moll et al. 1995; Ramos-Veras et al. 2003; Romih et al. 2005). However, Ogawa et al. (1999) reported in an induced carcinoma tumor model that the number of uroplakin positive cells decreased relative to tumor differentiation. Urothelial carcinomas, particularly of the prostatic urethra, have been reported in a colony of beagle dogs (Nikula et al. 1989).
Endoscopy
Published in Linda Cardozo, Staskin David, Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
Musaab Sarmad Yassin, John Michael Henderson, Francis Xavier Keeley
composed of squAmous (squAmous metAplAsiA) or glAndulAr (glAndulAr metAplAsiA) cells. squAmous metAplAsiA often hAs A knobby AppeArAnce And is covered by white, flAky, eAsily disrupted mAteriAl lying on the trigone. GlAndulAr metAplAsiA AppeArs As clumps of rAised red AreAs thAt AppeAr inflAmmAtory And Are often confused for cAncer. ApproximAtely 40% of women And 5% of men hAve squAmous metAplAsiA of the blAdder, which is usuAlly relAted to infection, trAumA, And surgery [14]. spinAl cord injury is AssociAted with squAmous metAplAsiA most likely from cAtheter trAumA And UTIs [7]. Cystitis CysticA And GlAndulAris (Figures 39.21 And 39.22) Cystitis cysticA And/or glAndulAris is A common finding in normAl blAdders, usuAlly AssociAted with inflAmmAtion or chronic obstruction [15]. Cystitis glAndulAris cAn be AssociAted with pelvic lipomAtosis And mAy occupy the mAjority of the blAdder. Cystitis glAndulAris mAy develop into or coexist with intestinAl metAplAsiA, which Are benign tumors. There hAve been A few cAse reports of cystitis cysticA or glAndulAris trAnsforming into AdenocArcinomA, And therefore regulAr endoscopic evAluAtion of pAtients with these entities is recommended [7,16]. Eosinophilic Cystitis (Figure 39.23A through d) eosinophilic cystitis mAy AppeAr As A red–brown pAtch cystoscopicAlly, And the diAgnosis cAn only be mAde by histologicAl evAluAtion.
Bladder neoplasms and NF-κB: an unfathomed association
Published in Expert Review of Molecular Diagnostics, 2020
Charles Emmanuel Jebaraj Walter, Sankari Durairajan, Kalaiselvi Periyandavan, George Priya Doss C, Dicky John Davis G, Hannah Rachel Vasanthi A, Thanka Johnson, Hatem Zayed
At the end of the 19th century, the relationship between inflammation and cancer was an expanding focus of research. Inflammatory conditions that occur before malignant changes are observed serve as one of the many probable triggers for some type of cancers. Conversely, an oncogenic change creates an inflammatory microenvironment that protects the progression of tumors in other types of cancer [17]. Inflammation is a self-limiting step, during which the cells are rescued from death due to damage caused by external factors or infection. Interstitial cystitis, proliferative cystitis (von Brunn’s nests), chronic cystitis, cystitis cystitica, cystitis glandularis, eosinophilic cystitis and follicular cystitis are a few inflammatory conditions that occur in the bladder (Figure 1). Interstitial cystitis (bladder pain syndrome) manifests suprapubic pain related to bladder filling, accompanied by an increased frequency of urination and other symptoms, with no urinary infection or other pathology. This condition results in classic inflammatory-type lesions that might appear microscopically with normal histology, mucosal ulceration, overlying fibrinous exudates and necrotic debris. The lamina propria is filled with chronic inflammatory cells, prominent mast cells, fibrosis and an absence of bacteria. There is a non-ulcer type of interstitial cystitis where the urothelium appears normal or can have multiple glomerulations [18]. The presence of von Brunn’s nests is observed in 85–95% of bladders, increasing with age. The nests consist of cytologically benign urothelium in the lamina propria with regular spacing extending to the same horizontal level at the base of proliferation. They sometimes extend with surface epithelium with minimal inflammation lacking a stromal reaction. The nested variant of urothelial carcinoma is mimicked in florid cases with no muscle invasion, which is usually mistaken for inverted papilloma, carcinoid tumors, paraganglioma and normal paraganglionic cells [19]. Cystitis glandularis is the transformation of mucosal cells lining the urinary bladder where they undergo glandular metaplasia (irritated tissues take on a gland form). These lesions are usually small microscopic foci that occasionally form raised intramucosal or polypoid lesions contained within the submucosa. They normally tend to bud from the surface mucosa and merge with von Brunn’s nests within the lamina propria and submucosa. Cystitis glandularis can be a non-mucinous and mucinous (intestinal) type. Individuals with diffuse intestinal-type cystitis glandularis are at an increased risk of developing bladder cancer. Like cystitis glandularis, cystitis cystica is a lesion arising from von Brunn’s nests but with a degenerated central cystic area [20].