Bladder Tumors: Kurt’s Notes [Video]

Thank you to Dr. Schaberg for his Amazing Notes. Please check out his website to access all of his notes: https://schaberg.faculty.ucdavis.edu/

Histology (Normal)
Normal anatomy – #urothelium, #laminapropria, #muscularispropria, #adventure
Normal variations – #vonbrunn nests, #cystitiscystica #cystitisglandularis

Pathology
Tumors — Flat
#carcinomainsitu CIS

Tumors – Papillary
#papilloma
#PUNLMP (Papillary Urothelial Neoplasm of Low Malignant Potential)
Non-invasive papillary urothelial carcinoma, low grade
Non-invasive papillary urothelial carcinoma, high grade

Inverted Urothelial Lesions
– Inverted Urothelial Papilloma
– Inverted Papillary urothelial carcinoma

Invasive Urothelial Carcinoma
– can have squamous, glandular, trophoblastic components
– specific variants include plasmacytoid, micropapillary, nested, lymphoepithelial-like, sarcomatoid

Remember if invades into muscularis propria (consider smoothelin +++), that leads to cystectomy/chemo

Other Epithelial Tumors
Squamous cell Carcinoma — Risk factor – Schistosoma haematobium
Neuroendocrine Tumors – Small cell carcinoma, large cell carcinoma, well-diff NET
Nephrogenic adenoma – Benign, stain with PAX8
Villous adenoma – Looks like a colonic tubular adenoma! Can progress to Adenocarcinoma. Get Beta-catenin to differentiate metastatic colonic adenocarcinoma (nuclear positive) v. bladder adenocarcinoma (not nuclear)
Urachal Carcinoma
Clear Cell Carcinoma
Polypoid #cystitis

Paraganglioma

Mesenchymal Lesions:
Inflammatory myofibroblastic tumor
Pseudosarcomatous myofibroblastic proliferation
leiomyosarcoma
#rhabdomyosarcoma, more likely embryonal subtype. MyoD1 and Myogenin +
#PEComa – HMB45 and SMA +
#angiosarcoma – atypical endothelial cells
#solitaryfibroustumor – staghorn vessels
#leiomyoma – SMA +
#hemangioma – No atypia in endothelial cells
#granular cell tumor – PASD, CD68, S100
#neurofibroma – Look for shredded carrot/diving dolphins – S100 + (not as diffuse as schwannoma) CD34+