Pathoma Lower Urinary Tract Carcinoma

Question 1

Urothelial carcinoma and where does it come from

Answer 1

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

Most common lower urinaty tract cancer that usually arises in the bladder

Question 2

Most common risk factor for urotehlial carcinoma

Answer 2

Smoking

Question 3

Who gets urotehlial carcinoma and how do they present?

Answer 3

older adults with painless hematuria

Question 4

Discuss the two pathways for urotehlial carcinoma

Answer 4

Flat - Starts as a high grade tumor that is spread out and starts as a p53 mutation. Right on top of lamina propria

Papillary - They start as a papillary rowth around a blood vessel with bumps on it growing out. tumors go from low grade to high grade to invasion

Question 5

Discuss field defect

Answer 5

Over time, carcinogens just keep hitting the tissue in a large area, all of it becoming mutated. This leads to multiple tumors arising at once and they can recur

Question 6

Discuss squamos cell carcinoma

Answer 6

malignant proliferation of squamos cells, usually involves the bladder.

Question 7

Risk factors for squamos cell

Answer 7

1. chronic cystitis
2. schistosoma hematobium - young middle eastern male. Infects the inside of the wall
3. long standing nephrolithiasis

Question 8

Adenocarcinoma and why it arises

Answer 8

Glands! Usually in the bladder…starting to see a pattern here…

Arises from urachal remnant, cystitis, glandularis, exstrophy

Question 9

Adenocarcinoma that arises from a urachal remnant will be present where?

Answer 9

Dome of the bladder

Question 10

Discuss the cystitis glandularis risk factor for adenocarcinoma?

Answer 10

Patient gets columnar metaplasia from chronic irritation in the bladder, which can spread to the nearby glands

Question 11

What is exstrophy?

Answer 11

Exposure of the bladder wall to the abdominal wall due to incomplete closure