Bladder diverticulum
Pouchlike evagination of the bladder wall as a consequence of persistent utethral obstruction.
Can lead to bladder stones.
Cystitis
Inflammation of the bladder lining.
Malakoplakia
Inflammatory disease due to defects in phagocytic or degradative function of macrophages. Leads to abundant granular material in cytoplasm of the macrophages.
Abnormal macrophages contain Michealis-Gutmann bodies.
Papillary tumor
Precursor lesions.
Grows outward (exophytic) into bladder lumen.
Spectrum (increasing severity):
Papilloma (benign)
PUNLMP (low malignant potential)
Low-grade carcinoma
High-grade carcinoma
Carcinoma in situ
Flat urothelium and presence of overtly malignant cells.
Invasive urothelial carcinoma
Tumor penetrates deeper layers:
Lamina propria
Muscle (muscularis propria)
Squamous cell carcinoma
Extensive keratinization and nearly always associated with chronic bladder irritation and infection.
Adenocarcinoma
Histologically identical to adenocarcinomas of the GI tract. Rare.
Treatment for bladder neoplasms
For low grade papillary tumors = resection
High risk of recurrence = tuberculosis BCG
High grade papillary cancer refractory to BCG = Radical cytectomy
Oncocytoma
Benign neoplasm of intercalated ducts of collecting ducts.
Loss of chromosomes 1 and Y
HISTO: oncocytoma
Plethora of mitochondria give them a tan color. Central stellate scar.
Renal cell carcinoma
renal tubular epithelium. Located predominantly in the cortex. sporadic or in association to VHL disease.
Types:
- Papillary
- Clear cell
- Chromophobe
Present with hematuria, fever, palpable abdominal mass. Metastasize to lungs and bones.
Clear cell carcinoma
Cells with clear cytoplasm. Invades renal vein frequently
Neoplastic cells appear vacuolated and almost solid. Numerous mitotic figures.
Papillary RCC
Papillary growth pattern with fibrovascular cores. Mutation on MET protooncogene.
They may show necrosis, hemorrhage and cystic degeneration. Pink cytoplasm.
Chromophobe renal carcinomas
Arise from intercalated and collecting ducts.
Cells stain darkly.
Wilms tumor
Common solid cancer in children.
Variety of cells derived from mesoderm.
