URINARY TRACT - Tumors (Robbins pp 1003)

• General: Represent 90% of all bladder tumours. Tumours classifed into low-grade / high-grade categories.
• Risk factors: smoking, exposure to dyes, schistosoma haematobium, cyclophosphamide (immunosuppressive agent), analgesic abuse
• WHO Classification:
  
• papilloma,
  
• Grade 1: papillary non-invasive,
  
• Grade 2: papillary, may be invasive,
  
• Grade 3: solid + invasive.
  
• If the tumour is graded as invasive, it is critical to stage the tumour also ≫ to obtain a prognosis.
• Clinical features: painless haematuria (classic)
• Morphology: 4 morphologic patterns ≫ Fig 22-8 pp 1004.
  
• Papilloma: finger like papilla arising from mucosa with fibrovascular stroma surrounded by normal transitional epithelium,
  
• Grade 1 TCC: closely resemble normal transitional cells, increased no. of cell layers,
• Grade II TCC: papillary/flat: increased no. of layers + mitotic activity, loss of polarity, pleomorphic cells,
  
• Grade III TCC: papillary/flat/both: invade into muscularis, cells flatten out resembling squamous cells, sometimes foci of glandular differentiation.

OTHER TUMOURS (Robbins Table 22-2)

SCC, adenocarcinoma (primary or direct invasion from rectum), small cell carcinoma, sarcoma.

Category: Pathology Notes