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Pathoma - Kidney and Urinary Tract Pathology > Lower Urinary Tract Carcinoma > Flashcards

Lower Urinary Tract Carcinoma Flashcards

1
Q

What is a Urothelial Carcinoma also known as?

A

Transitional Cell Carcinoma

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2
Q

What is a Urothelial (Transitional Cell) Carcinoma?

A

Malignant tumor arising from the urothelial lining of the renal pelvis, ureter, bladder or urethra

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3
Q

What is the most common type of lower urinary tract cancer?

A

Urothelial (Transitional Cell) Carcinoma

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4
Q

Where does Urothelial Carcinoma usually arise?

A

In the bladder!

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5
Q

What is the major risk factor for Urothelial Carcinoma?

A

Cigarette Smoke (esp. polycyclic aromatic hydrocarbons)

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6
Q

What are three additional risk factors for Urothelial Carcinoma?

A
  1. Naphthylamine
  2. Azo dyes
  3. Long-term cyclophosphamide or phenacetin use
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7
Q

What is a particularly high yield risk factor of urothelial carcinoma?

A

Long-term cyclophosphamide or phenacetin use

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8
Q

What does Urothelial Carcinoma classically present with?

A

Painless Hematuria

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9
Q

What population is Urothelial Carcinoma usually seen in?

A

Older adults

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10
Q

What are the two distinct pathways Urothelial Carcinoma arises?

A
  1. Flat

2. Papillary

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11
Q

How does a Flat Urothelial Carcinoma develop?

A

Starts as high grade urothelilal carcinoma.

Develops as high-grade flat tumor and then invades.

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12
Q

What is a Flat Urothelial Carcinoma associated with?

A

Early p53 mutations!!

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13
Q

How does a Papillary Urothelial Carcinoma develop?

A

Tumor develops as a low-grade papillary tumor that progresses to a high-grade papillary tumor and then invades

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14
Q

What is a Papillary Urothelial Carcinoma made of?

A

It’s a fibrovascular pore with a blood vessel running through the middle.

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15
Q

What is Papillary Urothelial Carcinoma NOT associated with?

A

Early p53 mutation

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16
Q

What are two common traits of Urothelial Carcinoma?

A
  1. Often Multifocal

2. Often recur

17
Q

Why is Urothelial Carcinoma often multifocal and recurrent?

A

Due to a “field defect”

18
Q

What is a “field defect”?

A

The entire urothelium has been hit with carcinogens over time so the entire surface is mutated.

19
Q

What is a Squamous Cell Carcinoma?

A

Malignant proliferation of squamous cells.

20
Q

What does a Squamous Cell Carcinoma often involve?

A

Bladder!

21
Q

What does squamous cell carcinoma arise in a background of?

A

Squamous metaplasia

22
Q

Why is it interesting that sqamous cell carcinoma arises in squamous metaplasia?

A

Because the normal bladder surface is not lined by squamous epithelium.

23
Q

What are three risk factors for Squamous Cell Carcinoma?

A
  1. Chronic cystitis (older women)
  2. Schistosoma haematobium (young, middle eastern men)
  3. Long-standing nephrolithiasis
24
Q

What is the general idea behind all Squamous Cell Carcinoma risk factors?

A

They all cause chronic inflammation/irritation.

25
Q

How does chronic cystitis lead to Squamous Cell Carcinoma?

A

Chronic inflammation –> Squamous metaplasia –> Squamous dysplasia –> Squamous cell carcinoma

26
Q

What is an Adenocarcinoma?

A

Malignant proliferation of glands

27
Q

What does an Adenocarcinoma usually involve?

A

Bladder!

28
Q

What three things can cause Adenocarcinoma?

A
  1. Urachal Remnant
  2. Cystitis Glandularis
  3. Exstrophy
29
Q

Where do urachal remnant Adenocarcinoma’s usually occur?

A

The tumor usually develops at the dome of the bladder.

30
Q

How does cystitis glandularis lead to adenocarcinoma?

A

Cystitis –> patient has chronic bladder inflammation –> get columnar metaplasia —> adenocarcinoma

31
Q

What is Exstrophy?

A

Congenital failure to form the caudal portion of the anterior abdominal and bladder walls (bladder exists outside body)

Pathoma - Kidney and Urinary Tract Pathology (9 decks)

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