Bladder cancer images
28 April 2023
I am now posting interesting cancer images, often from PathologyOutlines.com, the free online pathology textbook that I own. Click on the links to see the complete topic with its authors and editors.
Bladder cancer is the # 9 cause of U.S. cancer deaths with 16,710 deaths projected in 2023 (men 12,160, women 4,550). Men have a 4 times higher incidence than women. Major risk factors include cigarette smoking (accounting for 47% of U.S. bladder cancer cases); occupational exposure (dye, rubber, leather and aluminum industries, painters and firefighters); arsenic in drinking water; specific bladder birth defects and long term urinary catheters.
Note: information is often listed under “urinary bladder” to avoid confusion with the gall bladder.
The five year survival overall is 77% and is based on cancer stage (i.e. extent of disease). It is 96% for carcinoma in situ (cancer that has not spread beyond the basement member of bladder lining cells), 70% for local spread, 39% regional and 8% for distal spread.
Where is the bladder in relation to other organs?
Source: Wikipedia
The adult bladder rests on the rectum and seminal vesicles in males; in females, it rests on the cervix and vagina. Thus, a cystectomy for tumor may be combined with the removal of the prostate and seminal vesicles in men or with a hysterectomy and partial vaginectomy in women.
Urothelial carcinoma (transitional cell carcinoma)
The most common form of bladder cancer is urothelial carcinoma, also known as transitional cell carcinoma (TCC), which arises in the urothelial cells lining the bladder.
Urothelial cells also line other parts of the urinary tract, such as the part of the kidney that connects to the ureter (renal pelvis), the ureters and the urethra.
There are many subtypes of bladder cancer or bladder tumors, see the Table of Contents here. Treatment may vary based on the specific subtype.
Urothelial carcinoma - invasive: invasive urothelial carcinoma inverted growth pattern lipid-rich lymphoepithelioma-like microcystic micropapillary nested plasmacytoid poorly differentiated variant (including osteoclast rich giant cells) sarcomatoid variant with trophoblastic differentiation with glandular differentiation with squamous differentiation
Squamous cell neoplasms: condyloma acuminatum squamous cell carcinoma squamous cell papilloma verrucous carcinoma
Glandular neoplasms: adenocarcinoma adenocarcinoma in situ clear cell (adeno)carcinoma signet ring cell adenocarcinoma urachal adenocarcinoma villous adenoma
Neuroendocrine neoplasms: large cell neuroendocrine carcinoma paraganglioma small cell neuroendocrine carcinoma well differentiated neuroendocrine tumor
Other tumors: angiosarcoma inflammatory myofibroblastic tumor metastases plasmacytoma rhabdomyosarcoma
Images of bladder cancers:
Large bladder cancer has invaded more than half of the bladder muscle wall (muscularis propria).
Large bladder cancer is adjacent to the right ureter.
This bladder cancer is noninvasive. At the lower right, note that the tumor cells have not invaded below the usual lining (urothelial) layer. Tumor cells are low grade (i.e. have only mildly atypical features.
This bladder cancer is high grade. Note that the tumor cells are non-uniform - compare to the low grade tumor above.
This bladder cancer is invasive - it extends into the layer below the usual lining cells.
This aggressive (high grade) cancer has several mitotic figures (slightly above center and lower right). It is a rare neuroendocrine carcinoma of the bladder.
This image of neuroendocrine carcinoma of the bladder shows necrosis. The pink area represents the outline of dead tumor cells, which often occurs in aggressive tumors when they outgrow their blood supply.
This immunostain (immunohistochemical stain) of Ki-67 shows that almost half of the cancer cells are dividing (those that are dark brown), an indication of a high grade (aggressive) tumor.
End of discussion.
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