Non-urothelial bladder cancers
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Non-urothelial bladder cancers
Pathology
Renal and ureteral disorders
Renal agenesis
Horseshoe kidney
Potter sequence
Hyperphosphatemia
Hypophosphatemia
Hypernatremia
Hyponatremia
Hypermagnesemia
Hypomagnesemia
Hyperkalemia
Hypokalemia
Hypercalcemia
Hypocalcemia
Renal tubular acidosis
Minimal change disease
Diabetic nephropathy
Focal segmental glomerulosclerosis (NORD)
Amyloidosis
Membranous nephropathy
Lupus nephritis
Membranoproliferative glomerulonephritis
Poststreptococcal glomerulonephritis
Goodpasture syndrome
Rapidly progressive glomerulonephritis
IgA nephropathy (NORD)
Lupus nephritis
Alport syndrome
Kidney stones
Hydronephrosis
Acute pyelonephritis
Chronic pyelonephritis
Prerenal azotemia
Renal azotemia
Acute tubular necrosis
Postrenal azotemia
Renal papillary necrosis
Renal cortical necrosis
Chronic kidney disease
Polycystic kidney disease
Multicystic dysplastic kidney
Medullary cystic kidney disease
Medullary sponge kidney
Renal artery stenosis
Renal cell carcinoma
Angiomyolipoma
Nephroblastoma (Wilms tumor)
WAGR syndrome
Beckwith-Wiedemann syndrome
Bladder and urethral disorders
Posterior urethral valves
Hypospadias and epispadias
Vesicoureteral reflux
Bladder exstrophy
Urinary incontinence
Neurogenic bladder
Lower urinary tract infection
Transitional cell carcinoma
Non-urothelial bladder cancers
Renal system pathology review
Congenital renal disorders: Pathology review
Renal tubular defects: Pathology review
Renal tubular acidosis: Pathology review
Acid-base disturbances: Pathology review
Electrolyte disturbances: Pathology review
Renal failure: Pathology review
Nephrotic syndromes: Pathology review
Nephritic syndromes: Pathology review
Urinary incontinence: Pathology review
Urinary tract infections: Pathology review
Kidney stones: Pathology review
Renal and urinary tract masses: Pathology review
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Non-urothelial bladder cancers
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Non-urothelial bladder cancers
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| Laboratory value | Result |
| Hemoglobin | 12 g/dL |
| Hematocrit | 40% |
| Leukocyte count | 12,100/mm3 |
| Platelet count | 400,000/mm3 |
| Leukocyte count | 16000/mm3 |
| Neutrophils, segmented | 54% |
| Neutrophils, banded | 5% |
| Eosinophils | 12% |
| Basophils | 0% |
| Lymphocytes | 25% |
| Monocytes | 7% |
Reproduced from: Wikimedia Commons
If left untreated, this patient is most likely to develop which of the following complications?
Memory Anchors and Partner Content
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First Aid
2022
2021
2020
2019
2018
2017
2016
Bladder cancer
cisplatin/carboplatin for p. 448
hematuria, with p. 618
hypercalcemia and p. 221
oncogenic microbes and p. 224
Schistosoma haematobium p. , 158, 158
Hematuria p. 620
bladder cancer p. 624
Schistosoma haematobium
bladder cancer p. 224
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Rishi Desai, MD, MPHThere 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.
Squamous cell carcinomas typically arise in response to chronic irritation like from recurrent urinary tract infections, and long-standing kidney stones.
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.
Summary
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.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "Bladder Adenocarcinoma: A Persisting Diagnostic Dilemma" JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH (2017)
- "Bladder cancer, a review of the environmental risk factors" Environmental Health (2012)
- "Sensitivity and specificity of commonly available bladder tumor markers versus cytology: results of a comprehensive literature review and meta-analyses" Urology (2003)
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