12.9: Lower Urinary Tract Carcinoma Flashcards Preview

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

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

A
  • Renal pelvis
  • Ureter
  • Bladder
  • Urethra
2
Q

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

A

Urothelial carcinoma

3
Q

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

A
  • Malignant tumor arising from the urothelial lining of the lower urinary tract
  • Bladder
4
Q

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

A
  • Polycyclic aromatic hydrocarbons in cigarette smoke
  • Naphthylamine dyes
  • Azo dyes
5
Q

What are the two drugs that prediposed to urothelial carcinoma?

A

Long term cyclophosphamide or phenacetin

6
Q

What is the classic symptoms of urothelial carcinoma?

A

Painless hematuria

7
Q

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

A
  • Flat

- Papillary

8
Q

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

A
  • 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
Q

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

A

Flat build up of high grade epithelial carcinoma, then invades

10
Q

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

A

-p53 mutations early

11
Q

What is the “field defect” associated with urothelial carcinoma?

A

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

12
Q

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

A

Metaplastic squamous cell proliferation in the bladder

13
Q

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

A
  • Schistosoma haematobium
  • Chronic cystitis
  • Chronic nephrolithiasis
14
Q

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

A

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

15
Q

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

A
  • Liver
  • coat with host antigen
  • Goes to bladder to lay eggs, which are passed via micturition
16
Q

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

A
  • Bladder

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

17
Q

What is the urachus?

A

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

18
Q

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

A

The dome of the bladder

19
Q

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

A
  • Urachal remnant
  • Cystitis glandularis
  • Bladder Exstrophy
20
Q

What is cystitis glandularis?

A

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

21
Q

What is Bladder Exstrophy?

A

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