Urothelial Tract Flashcards
(21 cards)
What are Brunn nests?
A reactive proliferation change in the urothelium which represents invaginations of the urothelium into the lamina propria
What is cystitis cystica?
It is when Brunn nest become cystic ally dilated and develop a lumen
Can you have intestinal metaplasia in cystitis glandularis? Is it premalignant?
Yes it is call cystitis glandularis with intestinal metaplasia
No
What are some causes for the urothelium to undergo metaplasia?
UTI, calculi, frequent catheterization, diverticula
What area in the female GU tract is squamous differentiation considered a normal histologic variation and not metaplasia?
The trigone, because of estrogen effects
What is polypoid cystitis?
It is an exophytic, inflammatory lesion that is usually due to presence of indwelling catheters
Usually occurs at the dome or posterior wall of the bladder
Histologically there is a markedly edematous lamina propria
Where does tuberculous cystitis typically occur?
The bladder adjacent to the ureteral orifice
What is follicular cystitis?
When there are lymphoid follicles with germinal centers in the wall of the bladder
What does cyclophosphamide cause? How do you decrease this?
Hemorrhagic cystitis, due to metabolic byproducts
Forced fluids will reduce it
What’s the most common site in the GU tract for endometriosis?
The urinary bladder
In what group of men is endometriosis found to occur and what is the reasoning?
Men with history of prostate carcinoma receiving estrogen therapy
Thought to be due to activation of mullerian rests by exogenous estrogens
What does malacoplakia look like grossly? Histologically?
Solitary of confluent yellow nodules or plaques
The larger nodules are centrally umbilicated or ulcerated and the surrounding mucosa is hyperemic
It primarily involves the lamina propria, it is well demarcated, mixed inflammatory infiltrate in which epithelioid histiocytes predominate
These histiocytes have abundant eosinophilic cytoplasm with round or oval inclusions called Michaelis-guttman bodies
How is amyloid described histologically?
Eosinophilic and afibrillar in the laminar propria
What is the clinical picture of amyloid in the GU tract?
Hematuria and/or obstruction
What may amyloid deposits be associated with?
B-cell lymphoproliferative disorders
What are risk factors for bladder cancer?
Occupations in chemical, dyestuff, rubber, paint, and textile manufacturing also laboratory work, leather work and printing
Smoking
Where are urothelial papillomas most likely to occur?
The posterior or lateral walls of the bladder close to the ureteral orifices and the urethra
How are urothelial papillomas described grossly?
Papillary fronds lined by normal appearing urothelium that lack atypia
Superficial umbrella cells are often prominent, varying from inconspicuous to cuboidal cells with slightly enlarged nuclei and paler cytoplasm, to hobnail with abundant eosinophilic cytoplasm, to cells with prominent vacuolization
CK 20 is confined to the umbrella cells similar to normal urothelium
How are inverted papillomas of the urothelium described histologically?
Anastomosing islands and cords of normal urothelium originating from the overlying mucosa and growing downward into the stroma
Do not go into the muscularis propria
The base of the lesion is well circumscribed
Central portion contains urothelial cells (may be spindled) and the periphery demonstrates a basally located population of palisading cells
What is papillary urothelial neoplasm of low malignant potential?
Looks just like an exophytic papillary urothelial tumor but shows increased thickness of the urothelium
Does squamous metaplasia in urothelial carcinoma affect prognosis?
No
