Bladder and Prostate Pathology
|What is exstrophy?||Bladder opens directly through the abdomen|
|What is the urachus? What can go wrong with it?|| It is the track between the bladder and the umbilical cord that should be obliterated soon after birth|
- Can become a cyst, diverticulum, or remain completely patent
|What happens if ureter is denervated?||Loss of peristalsis and appropriate movement of urine > infection|
|What is a weird cause of UTI? How does it occur?||TB that is shed from renal TB into bladder|
|What is interstitial cystitis? Who gets it? What is a major concern associated with it?|| An extremely painful condition driven by hypersenstive nerves due to excessive T-Cell signaling / Idiopathic disease in women|
- Concern: Suicide rate is high
|What is nephrogenic adenoma / metaplasia?||Tubular epithelial cells that are sloughed off bind to bladder and grow there|
|Most common causes of urethritis?|| STDs - Gonorrhea, chlamydia, mycoplasma, ureaplasma|
- Also from catherization
|Neurogenic bladder||Bladder that has lost nerves > becomes bloated b/c of lack of signaling > produces tons of cytokines > massively swollen|
|Cystitis cystica / cystitis glandularis histological transformation:||Many goblet cells producing mucin are seen|
| Most common bladder tumor?|
When do they become an issue?
How do you grade the tumor?
| Urothelial (AKA transitional cell carcinoma) = Papillary and noninvasive tumors of low grade|
- Problems: 1. Invasion / 2. Grow to obstruct bladder > cystectomy needed
- Grade: nuclear atypia + mitotic figures
|Name the infectious disease and bladder tumor commonly seen together||Schistosomiasis + squamous cell carcinoma|
|Number one risk factor of bladder tumors?||Cigarette Smoking|
| Which tumors are more likely invasive - flat or papillary?|
Marker of invasion and prognosis?
| Flat are much more likely to be invasive, but both can become invasive|
DEPTH of downward invasion (flat can move down without moving upward!)
| Rhabdomyosarcoma occurs in what age group?|
Describe its appearance.
Describe difference in males and females
| 1. Bladder tumor seen in children|
2. Grape=like "Polypoid / "sarcoma botryoides"
3. Females: protrudes thru introitus / Males: Bladder obstruction
| What drives prostatic hyperplasia|
Describe growth and measuring scale.
Differentiate from prostatic cancer
| - ANDROGENS (inhibition of androgens > atrophy)|
- Growth is symmetric, circular and outward (Like a ball of tissue growing out) - Measured via Gleason Scale
- Cancer grows ASYMMETRICALLY in random directions!
|Complications of prostatic cancer?|| 1. Perineural invasion - grows along nerve|
2. Prostatic intraepithelial neoplasia (PIN)
3. Spread to vertebrae
4. Spread to lungs