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Non-urothelial bladder cancers
0 / 7 complete
0 / 1 complete
cisplatin/carboplatin for p. 448
hematuria, with p. 618
hypercalcemia and p. 221
oncogenic microbes and p. 224
Schistosoma haematobium p. , 158, 158
bladder cancer p. 624
bladder cancer p. 224
There are two types of bladder cancers—urothelial and non-urothelial types.
The urothelium is special type of transitional cell epithelium that forms a stretchy, protective barrier in the bladder. The majority of primary bladder tumors are urothelial cell carcinomas also known as transitional cell carcinomas that obviously originate from the urothelium.
Somewhat confusingly, non-urothelial tumors, like squamous cell carcinomas and adenocarcinomas, also often arise from the urothelium layer but are distinguished by the way that their cells differentiate.
For example, the normal bladder surface is not normally lined with squamous epithelium, yet the cells in the urothelium can change shape and take on a flat, pancake-like appearance of squamous cells. This non-cancerous change is called squamous cell metaplasia.
If these cells begin to grow unchecked they can turn into a squamous cell carcinoma. These tumors typically pop up in multiple locations, and show extensive keratinization, which is where the cytoplasm of the cells is filled with keratin, the same tough material in hair and nails.
Another cause, common in some parts of the world, is an infection with Schistosoma haematobium - a type of flatworm. In this infection, the infective larvae linger in the water and then burrow into human skin when given the opportunity, and travel to the liver to mature into adult flukes. From there young flukes migrate to the urinary bladder veins to sexually reproduce and lay eggs in the bladder wall. These eggs can get urinated out, but they also cause chronic inflammation in the bladder wall which is how they lead to squamous cell carcinomas.
Non-urothelial bladder cancers are a small subset of bladder cancers that confusingly, often arise from the urothelium. They include cancers like squamous cell carcinomas completely made of squamous cells, and adenocarcinomas entirely consisting of glandular cells. They are believed to arise from chronic irritation of the bladder, especially from an infection by a flatworm called Schistosoma haematobium. People with non-urothelial bladder cancer may present with hematuria, dysuria, urinary urgency and frequency, and weight loss.
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