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Flashcards in Bladder Deck (124)
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1

Urothelial carcinoma of the ureter: Main prognostic factors (3).

Stage.

Grade.

Presence of synchronous tumor in renal pelvis.

2

Malakoplakia: Typical patient.

Woman in her fifth decade.

3

Malakoplakia: Gross pathology.

Multiple soft, yellow-white, nodular plaques on the mucosa.

4

Histiocytes of malakoplakia:

A. Name.
B. Location.
C. Appearance.

A. Von Hansemann's histiocytes.

B. Superficial lamina propria.

C. Abundant eosinophilic granular cytoplasm.

5

Michaelis-Gutmann bodies of malakoplakia:

A. Location.
B. Composition.

A. Within the histiocytes and in the interstitium.

B. Bacteria encrusted with calcium and iron.

6

Malakoplakia: Other histopathologic features (2).

Fibrosis.

Acute and chronic inflammation.

7

Malakoplakia: Putative pathophysiology.

Mononuclear cells cannot degrade bacteria normally.

8

Clinical associations:

A. Polypoid cystitis.
B. Follicular cystitis (2).
C. Giant-cell cystitis.

A. Indwelling catheter.

B. Bladder carcinoma; urinary-tract infection.

C. None; a pathologic rather than clinical diagnosis.

9

Polypoid cystitis: Histopathology (2).

Broad fronds covered by benign urothelium.

Edematous, inflamed, congested lamina propria.

10

Giant-cell cystitis: Histopathology (2).

Atypical large cells with tapering processes; may be multinucleate.

Very few or no mitotic figures.

11

Granulomatous cystitis secondary to BCG therapy: Gross pathology.

Partial or complete mucosal denudation.

12

Granulomatous cystitis secondary to BCG therapy: Histopathology (3).

Lamina propria: Noncaseating granulomas surrounded by lymphocytes.

Urothelium: Reactive atypia or denudation.

13

Granulomatous cystitis secondary to BCG therapy: Special stains.

AFB stain rarely discloses bacteria.

14

Ureteritis cystica and ureteritis: Histopathology.

Both represent cystic change in von Brunn's nests.

Ureteritis glandularis: Lined by columnar cells.

15

Ureteritis cystica:

A. Etiology.
B. Gross pathology.

A. Inflammation.

B. Nodular mucosa secondary to cysts.

16

Urothelial carcinoma of the ureter: Risk factors (3).

Smoking.

Analgesics.

HNPCC.

17

Urothelial carcinoma of the ureter: Most frequent location.

Lower third of the ureter.

17

Radiation cystitis: Timing (2).

Acute symptoms: 4-6 weeks after radiation.

Later symptoms: Up to 10 years after radiation.

18

Radiation cystitis: Gross pathology.

Mucosal hyperemia and edema with thick folds.

19

Radiation cystitis: Earlier histopathology (4).

Lamina propria: Edema and hyperemia.

Urothelium: Atypia with preserved N:C ratio.

Vessels: Dilatation, fibrin deposition.

Stroma: Inflammation, extravasated erythrocytes.

20

Radiation cystitis: Later histopathology (3).

Lamina propria: Fibrosis.

Urothelium: Ulceration.

Vessels: Myo-intimal proliferation or medial hyalinization.

21

Hemorrhagic cystitis: Earlier histopathology (2).

Lamina propria: Hemorrhage, congestion.

Urothelium: Regenerative atypia.

22

Hemorrhagic cystitis: Later histopathology (2).

Lamina propria: Fibrosis.

Urothelium: Hyperplasia with formation of papillae.

23

Interstitial cystitis: Possible laboratory finding.

Hematuria.

24

Interstitial cystitis: Possible cystoscopic findings (3).

Petechial hemorrhage.

Linear ulcers.

Mucosal scarring.

25

Interstitial cystitis: Later gross finding.

Fibrotic and contracted bladder with diminished capacity.

26

Interstitial cystitis: Early histopathology.

Mucosal microhemorrhages.

27

Interstitial cystitis: Histopathology of ulcerative phase (3).

Fibroinflammatory infiltrate.

Increase in mast cells.

Hemorrhage, congestion, fibrosis.

28

Interstitial cystitis: Main differential diagnosis.

Carcinoma in situ must be excluded before interstitial cystitis can be diagnosed.

29

Cystitis glandularis: Immunohistochemistry.

CK20 highlights the umbrella cells only.