Urology Tumours of the Bladder
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The lecture has been given on Apr. 6th, 2011 by Dr. Ali Kamal.
![Urology<br />Neoplasms of the bladder<br />Ninety-five per cent of primary bladder tumours originate in :he epithelium; the remainder arise from connective tissue angioma, myoma, fibroma and sarcoma) or are extra adrenal phaeochromocytomas.<br />Secondary tumours of the bladder are not rare and most commonly arise from a neighbouring organ, particularly the sigmoid and rectum, the prostate, the uterus or ovary, although bronchial neoplasms also may spread to bladder.<br />Pathology<br />Benign papillary tumours. <br />Many histopathologists will not diagnose benign papillomas of the bladder, stating that most of them are merely better differentiated types of superficial bladder cancer. The papilloma consists of a single frond with a central vascular core with villi; it looks like a red sea-anemone (Figs 65.48 and 65.49). Inverted papilloma is a condition where the proliferative cells penetrate under normal mucosa so that the lesion is covered with smooth urothelium — it is benign.<br />Carcinoma of the bladder<br />Carcinoma arising within the bladder may be of three cell types: transitional, squamous and adenocarcinoma [or mixed owing to metaplasia in a transitional cell carcinoma (TCC)]. Over 90 per cent are transitional cells in origin. Pure squamous carcinoma is uncommon (approximately 5 per cent), apart from areas where bilharzia is endemic. Primary adenocarcinoma, which arises either from the urachal remnant or from areas of glandular metaplasia, accounts for 1—2 per cent of cases.<br />Transitional cell carcinoma<br />Aetiology. The first suspicion of a chemical cause for bladder cancer was raised by Rehn in 1894 when he recorded a series of tumours in workers in aniline dye factories. Hueper was able to show that 2-naphthylamine was carcinogenic in dogs. <br />Subsequent investigation demonstrated that the following compounds may be carcinogenic:<br />,[object Object]](https://image.slidesharecdn.com/bladdertumorsextended-110406133554-phpapp02/85/Urology-5th-year-3rd-lecture-extended-detailed-version-Dr-Ali-Kamal-1-320.jpg)
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- 6. o-toluidine;
- 10. Dye workers
- 11. Tyre rubber and cable workers
- 12. Petrol workers
- 13. Leather workers
- 14. Shoe manufacturers and cleaners
- 15. Painters
- 16. Hairdressers
- 17. Lorry drivers
- 19. Chemical workers