Pathology Of Ureter

Some normal histo: transitional epithelium in mucosa, lamina propria, muscularis mucosae, adventitia. Normal histo is important for staging tumors (levels of invasion)

1. Congenital abnormalities:

   1. double/bifrid ureter

   2. uretopelvic obstruction

   3. diverticulum (outpouching of mucosa, so that it grows into muscularis mucosae), can cause infections

   4. hydroureter, which just means that it is dilated (neurogenic problem, can’t propel urine). Hydroureter could also be acquired as a result of obstruction (ex: BPH) or vesicoureteral reflux. Megaloureter is massive enlargement of the ureter, probably due to a functional defect of the muscle .

2. Inflammation (ureteritis)

Usually it is secondary to UTI.

Specific types of ureteritis:

1. ureteritis follicularis, follicles or lymphoid aggregates are present under epithelium

2. ureteritis cystica, occurs as a result of infection, entrapment of epithelial cells in stroma (this is not neoplastic)

3. Tumors, extremely rare, but here they are in case you are interested:

Benign:

Leiomyoma

Malignant:

Mostly see metastasis from kidney, primarily malignant tumors are extremely rare.

Primary tumors are mainly of epithelial origin: transitional cell carcinoma.

4. Miscellaneous (Obstructive lesions of the ureter), which causes hydroureter  hydronephrosis  pyelonephritis

causes of obstruction in the ureter:

intrinsic: a. calculi

b. congenital stricture, or stricture due to sclerosing retroperitoneal fibrosis

c. tumors

d. bleeding, either a blood clot, or secondary to tumors or stones that are passing by

extrinsic: a. pregnancy

b. tumors (in bladder, prostate, etc.)

Category: Pathology Notes