Classification : Prostate Bladder Cancer
By prostate Doc at 27 August, 2008, 10:25 am
Anatomy
The normal bladder epithelium consists of transitional cell lining, up to seven cell layers thick. Deep to the urothelium is the subepithelial connective tissue (lamina propria or submucosa) which contains irregularly arranged smooth muscle fibers. The muscularis (detrusor muscle) is adjacent to the lamina propria and is surrounded by perivesical fat.
Microscopic Description
The tumor histology of most bladder cancers is (90%) transitional cell carci- noma. Typically, these tumors will have an increased number of cell layers, increased nuclear-to-cytoplasmic ratio, increased mitoses, and prominent nucleoli. The tu- mor growth can be papillary, sessile, nodular, mixed or flat (carcinoma in situ, CIS). Approximately two-thirds of all bladder cancers will be of the papillary variety. Carcinoma in situ is high-grade transitional cell carcinoma that is confined to the superficial urothelium. It occurs more commonly in men and can create symp toms that mimic prostatism and bladder irritability. Cystoscopically the mucosa can appear erythematous and is classically described as velvety in appearance. Pa- tients with CIS have higher tumor recurrence rates and often have positive urine cytologies (up to 90%). CIS can occur in association in up to 75% of muscle invasive cancers. Up to 20% of patients with bladder cancer have lymphatic or vascular metastases. Lymphatic spread usually occurs to the pelvic lymph nodes. Hematogenous me- tastases most commonly involve the following sites—liver, lung, bone, and adrenal
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