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Pathology Unit IX
Urinary Tract: Ureter and Urinary Bladder
30
Pathology
Graduate
04/18/2013

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Term
Common types of pathology to involve the ureters
Definition
obstruction/compression, stones, papillary transitional cell carcinoma
Term
Common etiologic agents of cystitis in men
Definition
obstruction of urine outflow due to benign prostatic hyperplasia
Term
Common etiologic agents of cystitis in women
Definition
reflux growth of perineal organisms, E. coli
Term
Symptoms of cystitis in men
Definition
frequeny lower abdominal pain, pain or burning on urination, fever, chills and general malaise
Term
Symptoms of cystitis in women
Definition
frequeny lower abdominal pain, pain or burning on urination, fever, chills and general malaise
Term
Clinical significance of cystitis in men
Definition
association with stones, diverticuli, and carcinoma
Term
Clinical significance of cystitis in women
Definition
infection can ascend to kidneys (pyelonephritis)
Term
General types of malignancy involving the urinary bladder
Definition
carcinoma, carcinoma in situ and precancerous lesions, and secondary tumors
Term
General incidence of transitional cell carcinoma
Definition
usual type of carcinoma of urinary bladder, more common in males in industrialized nations, and urban dwellers, 50- 70’s
Term
Pathogenesis of transitional cell carcinoma
Definition
related to Schistosomiasis, exposure to chemicals, dietary additives and smoking, painless hematuria
Term
Gross appearance of transtitional cell carcinoma
Definition
can be flat or lesions with endophytic growth pattern
Grading of transitional cell carcinoma: usually low grade papillary tumors
Term
Clinical course of transitional cell carcinoma
Definition
treated with curettage and installation of chemotherapeutic agent to cause sloughing of bladder mucosa, multifocal and reoccurring, flat and endophytic lesions are more aggressive
Term
Relative 5 year survival rate for transitional call carcinoma
Definition
60%
Term
Papilloma
Definition
- benign mucosal neoplasms sometimes classified as grade I papillary carcinoma. Less than
10% develop invasive carcinoma.
Term
Carcinoma
Definition
usual type of carcinoma of urinary bladder is transitional cell carcinoma. Squamous carcinoma,
adenocarcinoma, as well as sarcomas and secondary malignancies also involve bladder
Term
Intraepithelial changes in the urinary bladder that precede bladder carcinoma
Definition
hyperplasia --> atypical hyperplasia --> dysplasia --> carcinoma in situ
Term
Common tumors to involve the urinary bladder by direct extension
Definition
cervix, uterus, prostate and rectum
Term
Common causes of bladder obstruction in males
Definition
prostate enlargement of carcinoma
Term
Common causes of bladder obstruction in females
Definition
cystocele of bladder
Term
Morphological changes in the bladder resulting from obstruction of the neck of the bladder
Definition
obstruction leads to hypertrophy of bladder, diverticula and eventual hydronephrosis
Term
Incidence of bladder calculi
Definition
95% in men, less common than kidney stones
Term
Pathogenesis of bladder calculi
Definition
associated with urinary stasis, urinary infections, and foreign bodies
Term
associated with urinary stasis, urinary infections, and foreign bodies
Definition
can be asymptomatic or cause cause suprapubic pain, dysuria and hematuria
Term
Common types of fistulas that occur in the bladder
Definition
between bladder and vagina, rectum or uterus
Term
Causes of fistulas of the bladder
Definition
post surgical, crohn’s disease or diverticulitis or radiation therapy
Term
Clinical signfiance of fistulas of the bladder
Definition
can cause spontaneous bleeding, inflammation and infection
Term
The MOST common cause of cystitis is
Definition
Escherichia coli.
Term
A 3-year-old child became more irritable over a two month period and did not want to eat much at meals. On physical examination the pediatrician noted an enlarged abdomen and could palpate a mass on the right. An abdominal CT scan showed a 10 cm solid mass involving the right kidney. The resected mass had the microscopic appearance of small blue cells with primitive tubular structures. The child received chemotherapy and radiation therapy, and there was no recurrence.
Which of the following conditions did this child most likely have?
Definition
Wilms tumor
Term
Which primary malignancy occurs in structures lined by urothelium, such as the renal pelvis, urinary bladder and ureter?
Definition
transitional cell carcinoma
Term
A urinary bladder biopsy from a patient with a long history of schistosomiasis was examined. The biopsy showed extensive chronic inflammation and widespread metaplasia. The patient is at highest risk for developing which of the following tumors?
Definition
Squamous cell carcinoma
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