Lower Urinary Tract Pathology: Handorf Flashcards
What is a cystocele?
Falling of bladder out of urethra
When is vesicoureteral reflux a problem?
Acute angle of ureter and valve into bladder prevents gravity from making pee go into bladder and not back into kidneys. Acute angle makes full bladder clamp off ureter.
Malformation can be errors.
What is the most common cause of LUTI?
Colonic bacteria
BOARDS: What is Malakoplakia?
Histiocyte disorder.
Cannot clear infections.
BOARDS: What is the microscopic feature of malakoplakia?
Michaelis-Newton body: Dense target like inclusions in cytoplasm of histiocytes
BOARDS: What does malakoplakia look like grossly?
Cancer… knobby protrusions
What is interstitial cystitis?
Persistent, chronic cystitis of interstitial of bladder
Intermittent severe suprapubic pain, frequesncy, urgency, blood, etc…
NO BACTERIAL INFECTION!
What are the histologic features of interstitial cystitis?
Inflammation and fibrosis
All layers of bladder wall
Mucosal ulcers: Hunner ulcers
What is the etiology of interstitial cystitis?
Unknown… autoimmune?
What is cystitis glandular is associated with?
Long recurrent infection
Adenocarcinoma of bladder
What is cystitis glandular is?
Chronic formation of glands in bladder after persistent inflammation= metaplasia
Buzzword for bladder cancer?
SMOKING
What percent of people who smoke have urothelial dysplasia? bladder cancer?
Dysplasia: 100%
Cancer: 20%
What is notable about the distributions of cancer in the bladder?
Often multifocal
What two ways do bladder cancers usually grow?
Papillary
Invasive
What is trigone lined with?
Squamous cells
BOARDS: What causes squamous cell carcinoma of bladder?
Schistosoma hematombium: nile river delta
Egyptian immigrant with bladder cancer. What type?
Squamous cell due to schistosoma hematobium
What is adenocarcinoma?
GI cancer… glandular. Same tx for colon cancer.
What are benign neoplasms of bladder?
Leiomyoma (Most common of benign tumors)
Menangioma
Granular cell tumor
Neurofibroma
How common are benign neoplasms of bladder?
Pretty rare
What are malignant sarcomas of bladder?
Rhabdomyosarcoma
Leiomyosarcoma
What age are Rhabdomyosarcomas?
> 40
Kids. Grape like projections.
What bladder sarcomas are more common in adults?
Leiomyosarcoma
What is the gross appearance of rhabdo? Leiosarc?
Rhabdo: grapes
Leiosarc: ulcerated and circumscribed
What happens in dye study of tumor in bladder?
Hydronephrosis of calyces
Rhabdomyosacroma botryoides buzzword?
Kids bladder tumor
Grape like clusters
Non-gonococcla urethritis caused by?
E coli
Chlamydia
Mycoplasma
What is urethritis associated with MS?
Reiter’s syndrome: artritis, conjuctivitis, urethritis
What are urethral tumors?
Caruncle: vascularized young connective tissue with leukocytes
Papilloma: usually on external meatus, viral origin, HPV
Carcinoma: rare, old age, squamous cell carcinoma…. more aggressive than bladder cancer
Whites are how many times more common to get testicular cancer?
6 times! 6/100k vs asians 1/100k
What type of testicular tumor is most common?
Mixed germ cell type
