Bladder cancer pathophysiology
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Steven C. Campbell, M.D., Ph.D.
Overview
Genes involved in the pathogenesis of bladder cancer include HRAS, Rb1, PTEN/MMAC1, NAT2, and GSTM1.
Pathogenesis
- Under normal conditions, the bladder, the lower part of the kidneys (the renal pelvises), the ureters, and the proximal urethra are lined with a specialized mucous membrane referred to as transitional epithelium (also called urothelium).
- Most cancers that form in the bladder, the renal pelvises, the ureters, and the proximal urethra are transitional cell carcinomas (also called urothelial carcinomas) that derive from transitional epithelium.
- Urothelial carcinomas may be non-invasive (only in the lining of the bladder) or invasive (growing into other layers of the bladder wall).
Genetics
Genetic mutations:
Gross Pathology
- On gross pathology, flat lesions or papillary lesions are characteristic findings of non-invasive urothelial carcinoma.
- Invasive urothelial carcinoma
Microscopic Pathology
- Flat lesions
- On microscopic histopathological analysis, loss of cell polarity, nuclear crowding, and nuclear crowding are characteristic findings.
- Papillary lesions
- On microscopic histopathological analysis, fibrovascular stalks, umbrella cells, and eosinophilic cytoplasm are characteristic findings.
- Invasive urothelial carcinoma
References
- ↑ 1.0 1.1 Cheng L, Cheville JC, Neumann RM, Bostwick DG (2000). "Flat intraepithelial lesions of the urinary bladder". Cancer. 88 (3): 625–31. PMID 10649257.
- ↑ Cheng L, Cheville JC, Neumann RM, Bostwick DG (1999). "Natural history of urothelial dysplasia of the bladder". Am J Surg Pathol. 23 (4): 443–7. PMID 10199474.
- ↑ McKenney JK, Amin MB, Young RH (2003). "Urothelial (transitional cell) papilloma of the urinary bladder: a clinicopathologic study of 26 cases". Mod Pathol. 16 (7): 623–9. doi:10.1097/01.MP.0000073973.74228.1E. PMID 12861056.
- ↑ Picozzi S, Casellato S, Bozzini G, Ratti D, Macchi A, Rubino B; et al. (2013). "Inverted papilloma of the bladder: a review and an analysis of the recent literature of 365 patients". Urol Oncol. 31 (8): 1584–90. doi:10.1016/j.urolonc.2012.03.009. PMID 22520573.