Lesson 4C (Part 2) Flashcards Preview

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Flashcards in Lesson 4C (Part 2) Deck (30)
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1

Transitional Cell Carcinoma

Cancer that forms in the transitional cells in the lining of the bladder, ureter or renal pelvis

2

TCC

Transitional Cell Carcinoma

3

What is the nature of TCC? (2)

1. Multifocal
2. Bilateral

4

Who is TCC more common in?

Men
- 65 years of age

5

What is a symptom of TCC? (2)

1. Flank pain
2. Gross or microscopic hematuria

6

What can fat within the renal sinus appear as?

A mass and simulate TCC

7

What is necessary to confirm TCC? (2)

1. IVU
2. CT

8

What does TCC look like on US? (3)

1. Discrete
2. Solid
3. Central hypoechoic renal sinus mass

9

What are 3 differential diagnosis for TCC?

1. Blood clots
2. Sloughed papillae
3. Fungus balls

10

What does TCC rarely invade?

The renal pelvis

11

How much does ureteral TCC account for in all the upper urinary tract cancers?

1-6%

12

Who is most affect by ureteral TCC?

Men
- 50-70 years of age

13

What are the S/S of ureteral TCC? (4)

1. Hematuria
2. Frequency
3. Dysuria
4. Pain

14

What is the sonographic appearance of ureteral TCC? (3)

1. Hydronephrosis
2. Hydroureter
3. Occasionally solid ureteral mass is seen

15

What is necessary with ureteral TCC? (2)

1. IVU
2. Retrograde pyelography

16

What is the most common malignant tumour?

Bladder TCC

17

Who is most affect by bladder TCC?

Men
- 60-70 years of age

18

What part of the bladder is affect by TCC? (3)

1. Trigone
2. Lateral walls
3. Posterior walls

19

What are the S/S of bladder TCC? (4)

1. Hematuria
2. Frequency
3. Dysuria
4. Suprapubic pain

20

What is easy to detect with a full bladder?

Detection of polypoid tumours

21

What can help to demonstrate the vascular stalk (pedicle)?

Colour doppler

22

What is necessary for the diagnosis of bladder TCC? (2)

1. Cystoscopy
2. Biopsy

23

What does bladder TCC look like sonographically? (2)

1. Nonmobile focal mass ***
2. May calcify

24

How do you tell if a mass can move or not?

Turn the patient into decubitus position
- if the mass moves its probably a clot

25

What is the differential diagnosis of bladder TCC? (9)

1. Cystitis
2. Wall thickening
3. Postradiation change
4. Blood clot
5. Invasive prostatic carcinoma
6. Lymphoma
7. Metastasis
8. Endometriosis
9. Neurofibromatosis

26

How much more common is bladder TCC compared to renal elvis TCC?

50x

27

Why is bladder TCC more common compared to renal elvis TCC?

Due to its larger surface area

28

Why is renal TCC 2-3X's more common than ureteral TCC?

Because of its multifocal and bilateral nature
- may develop upper tract lesion when bladder TCC is apparent

29

Bladder outlet obstruction

Blockage at the base of the bladder that reduces or prevents the flow of urine into the urethra

30

What are the causes of bladder outlet obstruction? (4)

1. Enlarged prostate
2. Stones
3. Tumours
4. Scar tissue