Bladder cancer Flashcards
Because invasion of the (1) layer of the bladder greatly affects the prognosis and survival rate of bladder cancer, it is not surprising that (2) lesions can have a worse prognosis than (3) lesions which are exophytic growths within the (4)
- muscle
- flat carcinoma-in-situ
- papillary
- bladder lumen
(1) is an important predictor of bladder cancer prognosis because only about 10% of low grade cancers (2) whereas nearly 80% of high grade ones (2)
- Nuclear grade
2. invade muscle
Invasive bladder cancers can invade local structures like (1) and tend to spread to (2) before metastasizing to (3)
- prostate, seminal vesicle and ureter
- regional lymph nodes
- liver, lungs or bone marrow
Flat transitional cell carcinomas often present as (1). They can be (2) and extensive.
- reddish areas of bladder wall thickening without a clear mass
- multifocal
The precursor for invasive flat transitional cell carcinomas are (1) which is usually high nuclear grade
- transitional cell carcinoma-in-situ (CIS)
Papillary transitional cell carcinomas of the bladder may develop from (1) and often become (2) lesions which can extend into the (3)
- papillary urothelial hyperplasia
- exophytic
- bladder lumen
Like at other sites, papillary carcinoma within the bladder consists of (1) cells which surround a central core which contains (2).
- atypical pleiomorphic
2. connective tissue and blood vessels
(1) can be extensive and give a cauliflower like appearance to the tumors grossly
- Papillary fronds of papillary transitional cell carcinomas of the bladder
Invasive bladder cancer is usually (1), although worldwide about 10% is (2), associated with (3) which causes a premalignant (4) metaplasia
- transitional epithelium
- squamous cell carcinoma
- schistosomiasis mansoni
- squamous
Unlike other sites in the body (except skin) where cancers are usually single, bladder cancer can occur at multiple sites at the same time, so it is (1) in nature
- multifocal
Classically, bladder cancers present with (1) which can either be visible to the patient or physician or only present by microscopic exam
- painless hematuria
If the cancer enlarges, it can lead to urethral obstruction which would present as (1) (inability to begin urine flow) or (2) (a sudden feeling that you need to urinate ) or (3) (painful urination).
- hesitancy
- urgency
- dysuria
(1) is an important risk factor for bladder cancer and some occupational or environmental exposures are associated with the development of bladder cancer including (2)
- Cigarette smoking
2. 2 napthylamine and pelvic irradiation
(1) can cause a hemorrhagic cystitis (inflammation of the bladder) which is associated with an increased risk of bladder cancer
- Cyclophosphamide
Mutations which are associated with bladder cancer include?
p16, p53 and a loss of chromosome 9
One approach to screening symptomatic patients for bladder cancer is (1) in which malignant cells are identified because of their nuclear changes and increased nuclear to cytoplasmic ratio
- urine cytology