Lower urinary carcinomas 12/21

Question 1

3 types of lower urinary tract carcinoma?

Answer 1

urotherial (transitional cell) carcinoma
Squamous cell carcinoma
Adenocarcinoma

Question 2

Urotherial (transitional cell) carcinoma. arise where?

Answer 2

Maglinant tumor arising from urothelial lining of the renal pelvis, ureter, blader or urethra.

Question 3

Maglinant tumor arising from urothelial lining of the renal pelvis, ureter, blader or urethra.?

Answer 3

Urotherial (transitional cell) carcinoma.

Question 4

Most common lower carcinoma?

Answer 4

Urotherial (transitional cell) carcinoma. Most commonly in bladder

Question 5

Urotherial (transitional cell) carcinoma. what predisposes?

Answer 5

1. Cigarette smoke -> naphthylamine,
2. Occupationa: rubber, plastics, aromatic amine-containing dyes, textile, leather.
3. Cyclophosphamide or phenacetin use, 4. Schistosoma haematobium (in african/middle east)

Question 6

Cigarette smoke; naphthylamine, azo dyes, long-term cyclophosphamide or phenacetin use.?

Answer 6

Urotherial (transitional cell) carcinoma.

Question 7

Urotherial (transitional cell) carcinoma. in what population?

Answer 7

older adults
>60 y/o,
males>females

Question 8

Urotherial (transitional cell) carcinoma. classically presents as?

Answer 8

painless hematuria

Question 9

Urotherial (transitional cell) carcinoma. What are two distinct pathways?

Answer 9

Flat and papillary

Question 10

Urotherial (transitional cell) carcinoma. Flat type. what grades and mutation?

Answer 10

develops as a high-grade flat tumor and then invades
assoc. with early p53 mutation

Question 11

develops as a high-grade flat tumor and then invades
assoc. with early p53 mutation?

Answer 11

Urotherial (transitional cell) carcinoma. Flat type

Question 12

Urotherial (transitional cell) carcinoma. Papillary type. grade, progression. what mutation?

Answer 12

develops as a low-grade papillary tumor that progresses to high-grade papillary tumor and the invades. Not associated with early p53 mutation.

Question 13

Urotherial (transitional cell) carcinoma. what one more feature regarding reccurance?

Answer 13

tumors are often multifocal and recur-pasikartojantis (,,field defect”)

Question 14

Squamous cell carcinoma. definition?

Answer 14

malignant proliferation of squamous cells, usually involving the bladder

Question 15

malignant proliferation of squamous cells, usually involving the bladder?

Answer 15

Squamous cell carcinoma.

Question 16

Squamous cell carcinoma. arises in the background of what?

Answer 16

squamous metaplasia (normal bladder surface is not lined by squamous epithelium)

Question 17

Squamous cell carcinoma. risk factors?

Answer 17

chronic cystitis (older women), schistosoma haematobium infection (egyptian male), long standing nephrolithiasis

Question 18

chronic cystitis (older women), schistosoma haematobium infection (egyptian male), long standing nephrolithiasis?

Answer 18

Squamous cell carcinoma.

Question 19

Adenocacinoma. definition?

Answer 19

malignant proliferation of glands, usually involving bladder

Question 20

malignant proliferation of glands, usually involving bladder?

Answer 20

Adenocacinoma.

Question 21

Adenocacinoma. Arises from what?

Answer 21

urachal remnant, cystitis glandularis or extrophy.

Question 22

Adenocacinoma. Urachal remnant. where develops carcinoma?

Answer 22

tumor develops at the dome of the bladder

Question 23

Adenocacinoma. tumor develops at the dome of the bladder?

Answer 23

Urachal remnant.

Question 24

Adenocacinoma. extrophy?

Answer 24

congenital failure to form the caudal portion of the anterior abdominal and baldder walls

Question 25

Adenocacinoma. congenital failure to form the caudal portion of the anterior abdominal and baldder walls

Answer 25

extrophy

Question 26

chronic cystitis (older women)?

Answer 26

Squamous cell carcinoma.

Question 27

schistosoma haematobium infection (african/middle east)?

Answer 27

Squamous cell carcinoma as well as urothelial

Question 28

long standing nephrolithiasis?

Answer 28

Squamous cell carcinoma.

Question 29

urothelial. Cystoscopy - diagnostic method to confirm diagnosis (nu siaip biopsy xddd) - what see?

Answer 29

urothelial cancer grows as erythematous papillary, nodular or sessile (flat) mass/lesions.

Question 30

urothelial. microscopy.

Answer 30

may show cells resembling normal bladder epithelium but with irregular architecture, pleomorphism, hyperchromatic nuclei, an increased nucleus/cytoplasm ratio, and disrupted orientation and polarity (in relation to the basement membrane), and atypical (frequent) mitoses.

Question 31

urothelial. the most important factor for determing prognosis? based on what?

Answer 31

tumor STAGE
based on the depth of invasion into the bladder wall and the degree of regional (eg lymph nodes) and metastatic spread.

Question 32

urothelial. Invasion in what already carries a unfavourable prognosis?

Answer 32

Tumor invasion into the muscularis propria layer (indicating stage T2 or higher in the Tumor, Node, Metastasis [TNM] system) of the bladder wall carries an unfavorable prognosis.

Question 33

larger tumors assoc with what?

Answer 33

worse prognosis

Question 34

size of tumor vs invasion?

Answer 34

depth of tumor invasion is much more important factor than tumor size

Question 35

urotheliai. papillary. composition?

Answer 35

urothelium supported by a thin fibrovascular stalk.

Question 36

urothelial. papillary. where tend to extent/grow?

Answer 36

prone to grow into the bladder lument than bladder wall.