Difference between revisions of "Urinary bladder"

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The '''urinary bladder''' stores urine until one has to go wee-wee. It is commonly afflicted by [[cancer]].
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]].


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>
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>


=Normal=
=Normal=
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Note:
Note:
*On TURBT - don't ever call T3.
*On TURBT - don't ever call pT3.
 
=Grossing=
:[[AKA]] ''cut-up''.
{{Main|Partial cystectomy}}
{{Main|Radical cystectomy}}
{{Main|Cystoprostatectomy}}


=Urinary bladder cancer=
=Urinary bladder cancer=
Line 33: Line 39:


==Squamous cell carcinoma of the urinary bladder==
==Squamous cell carcinoma of the urinary bladder==
{{Main|Squamous cell carcinoma}}
{{Main|Squamous cell carcinoma of the urinary bladder}}
*Rare type of bladder cancer.
*''Urothelial carcinoma with squamous differentiation'' is much more common.
 
==Urachal carcinoma==
{{Main|Urachal carcinoma}}
 
==Rhabdomyosarcoma of the urinary bladder==
{{Main|Rhabdomyosarcoma}}
===General===
===General===
*Strong association with ''Schistosoma haematobium''.<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>
*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>
**Common in areas with ''S. haematobium''.
**Uncommon in areas without ''S. haematobium''.


===Microscopic===
===Microscopic===
Features:
:See ''[[rhabdomyosarcoma]]''.
*See ''[[squamous cell carcinoma]]'' article.


==Urachal carcinoma==
DDx:
{{Main|Urachal carcinoma}}
*Rhabdomyosarcomatous sarcomatoid carcinoma - more common than RMS in adults.
**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==
==Urinary bladder infarct==
{{Main|Infarction}}
{{Main|Infarction}}
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*Liquefaction implies an infectious etiology.<ref name=pmid3394185/>
*Liquefaction implies an infectious etiology.<ref name=pmid3394185/>


==Rhabdomyosarcoma of the urinary bladder==
==Urinary bladder amyloidosis==
{{Main|Rhabdomyosarcoma}}
{{Main|Urinary bladder amyloidosis}}
===General===
 
*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>
==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}}


===Microscopic===
==Leiomyoma of the urinary bladder==
:See ''[[rhabdomyosarcoma]]''.
{{Main|Leiomyoma of the urinary bladder}}


DDx:
==Cystitis==
*Rhabdomyosarcomatous sarcomatoid carcinoma - more common than RMS in adults.
:See ''[[urothelium]]''.
**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.


=See also=
=See also=

Latest revision as of 03:23, 17 January 2017

The urinary bladder stores urine between urination, i.e. trips to the washroom 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

  • Rare type of bladder cancer.
  • Urothelial carcinoma with squamous differentiation is much more common.

Urachal carcinoma

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.

Metastasis to the urinary bladder

Other

Urinary bladder infarct

General

Microscopic

Features:[4]

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

Note:

  • Liquefaction implies an infectious etiology.[4]

Urinary bladder amyloidosis

Tubular adenoma of the urinary bladder

Keratinising squamous metaplasia of the urinary bladder

Leiomyoma of the urinary bladder

Cystitis

See urothelium.

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 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.