Lower Urinary Tract Pathology: Handorf

Question 1

What is a cystocele?

Answer 1

Falling of bladder out of urethra

Question 2

When is vesicoureteral reflux a problem?

Answer 2

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.

Question 3

What is the most common cause of LUTI?

Answer 3

Colonic bacteria

Question 4

BOARDS: What is Malakoplakia?

Answer 4

Histiocyte disorder.

Cannot clear infections.

Question 5

BOARDS: What is the microscopic feature of malakoplakia?

Answer 5

Michaelis-Newton body: Dense target like inclusions in cytoplasm of histiocytes

Question 6

BOARDS: What does malakoplakia look like grossly?

Answer 6

Cancer… knobby protrusions

Question 7

What is interstitial cystitis?

Answer 7

Persistent, chronic cystitis of interstitial of bladder

Intermittent severe suprapubic pain, frequesncy, urgency, blood, etc…

NO BACTERIAL INFECTION!

Question 8

What are the histologic features of interstitial cystitis?

Answer 8

Inflammation and fibrosis
All layers of bladder wall
Mucosal ulcers: Hunner ulcers

Question 9

What is the etiology of interstitial cystitis?

Answer 9

Unknown… autoimmune?

Question 10

What is cystitis glandular is associated with?

Answer 10

Long recurrent infection

Adenocarcinoma of bladder

Question 11

What is cystitis glandular is?

Answer 11

Chronic formation of glands in bladder after persistent inflammation= metaplasia

Question 12

Buzzword for bladder cancer?

Answer 12

SMOKING

Question 13

What percent of people who smoke have urothelial dysplasia? bladder cancer?

Answer 13

Dysplasia: 100%
Cancer: 20%

Question 14

What is notable about the distributions of cancer in the bladder?

Answer 14

Often multifocal

Question 15

What two ways do bladder cancers usually grow?

Answer 15

Papillary

Invasive

Question 16

What is trigone lined with?

Answer 16

Squamous cells

Question 17

BOARDS: What causes squamous cell carcinoma of bladder?

Answer 17

Schistosoma hematombium: nile river delta

Question 18

Egyptian immigrant with bladder cancer. What type?

Answer 18

Squamous cell due to schistosoma hematobium

Question 19

What is adenocarcinoma?

Answer 19

GI cancer… glandular. Same tx for colon cancer.

Question 20

What are benign neoplasms of bladder?

Answer 20

Leiomyoma (Most common of benign tumors)
Menangioma
Granular cell tumor
Neurofibroma

Question 21

How common are benign neoplasms of bladder?

Answer 21

Pretty rare

Question 22

What are malignant sarcomas of bladder?

Answer 22

Rhabdomyosarcoma

Leiomyosarcoma

Question 23

What age are Rhabdomyosarcomas?

Answer 23

> 40

Kids. Grape like projections.

Question 24

What bladder sarcomas are more common in adults?

Answer 24

Leiomyosarcoma

Question 25

What is the gross appearance of rhabdo? Leiosarc?

Answer 25

Rhabdo: grapes
Leiosarc: ulcerated and circumscribed

Question 26

What happens in dye study of tumor in bladder?

Answer 26

Hydronephrosis of calyces

Question 27

Rhabdomyosacroma botryoides buzzword?

Answer 27

Kids bladder tumor

Grape like clusters

Question 28

Non-gonococcla urethritis caused by?

Answer 28

E coli
Chlamydia
Mycoplasma

Question 29

What is urethritis associated with MS?

Answer 29

Reiter’s syndrome: artritis, conjuctivitis, urethritis

Question 30

What are urethral tumors?

Answer 30

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

Question 31

Whites are how many times more common to get testicular cancer?

Answer 31

6 times! 6/100k vs asians 1/100k

Question 32

What type of testicular tumor is most common?

Answer 32

Mixed germ cell type