12.9: Lower Urinary Tract Carcinoma Flashcards Preview

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Flashcards in 12.9: Lower Urinary Tract Carcinoma Deck (21):
1

What, technically, is included in the lower urinary tract?

-Renal pelvis
-Ureter
-Bladder
-Urethra

2

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

Urothelial carcinoma

3

What, generally, is urothelial carcinoma? Where, anatomically, is this most often found?

-Malignant tumor arising from the urothelial lining of the lower urinary tract
-Bladder

4

What is the main risk factor for urothelial carcinoma? (3)

-Polycyclic aromatic hydrocarbons in cigarette smoke
-Naphthylamine dyes
-Azo dyes

5

What are the two drugs that prediposed to urothelial carcinoma?

Long term cyclophosphamide or phenacetin

6

What is the classic symptoms of urothelial carcinoma?

Painless hematuria

7

What are the two distinct pathways in the pathogenesis of urothelial carcinoma?

-Flat
-Papillary

8

What is the papillary pathway of urothelial carcinoma? What is the progression here?

-Papillary growth with a fibrovascular core and a blood vessel running through it, and upon which epithelium is placed

-Low grade to high grade to invasion

9

What is the flat pathway of urothelial carcinoma? What is the progression here?

Flat build up of *high grade* epithelial carcinoma, then invades

10

Why does the flat pathway of urothelial carcinoma development start with high grade malignant cell proliferation?

-p53 mutations early

11

What is the "field defect" associated with urothelial carcinoma?

The entire urothelial lining has been chronically insulted by carcinogens, meaning that all of it will eventually form tumors

12

What does squamous cell carcinoma usually arise from within the lower urinary tract? Where (anatomically)?

Metaplastic squamous cell proliferation in the bladder

13

What are the three risk factors for the development of *squamous cell carcinoma* of the lower urinary tract (infx agent, chronic diseases x2)

-Schistosoma haematobium
-Chronic cystitis
-Chronic nephrolithiasis

14

What is Schistosoma haematobium? In whom is this commonly seen, and how?

Parasite found in middle eastern males transmitted by water, and leads to squamous cell carcinoma of the bladder.

15

Where does Schistosoma haematobium reside in the human body? How does it evade immune detection? Where does it go to lay eggs?

-Liver
-coat with host antigen
-Goes to bladder to lay eggs, which are passed via micturition

16

Where does adenocarcinoma of the lower urinary tract usually arise from? Why?

-Bladder
-arises from failure of involution of the urachal remnant, which is glandular

17

What is the urachus?

Duct that connects the fetal yolk sac with the bladder to allow the bladder to drain waste into the yolk sac

18

If adenocarcinoma is caused by failure of the urachal remnant to involunt, where in the bladder will it be seen?

The dome of the bladder

19

What are the three major causes of adenocarcinoma of the bladder?

-Urachal remnant
-Cystitis glandularis
-Bladder Exstrophy

20

What is cystitis glandularis?

Chronic inflammation of the bladder leads to dysplasia of the bladder epithelium to columnar epithelium

21

What is Bladder Exstrophy?

Congenital failure to form the inferior portion of the bladder and abdominal walls, exposing the surface of the bladder to the outside world