Transitional cell carcinoma

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Transitional cell carcinoma

Renal system


Transitional cell carcinoma


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Transitional cell carcinoma

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USMLE® Step 1 style questions USMLE

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An 83-year-old man comes to the office for a routine evaluation. The patient recently noticed that his urine has pinkish tinge, but he denies dysuria or abdominal pain. Medical history is unremarkable, and physical examination shows no abnormalities. Repeated urinalysis shows 5-10 RBC/hpf, and the urine is pinkish-red in color. Cystoscopy with biopsy is obtained, and the results are shown below.  

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Which of the following is the most common risk factor associated with this patient's condition?  

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Aniline dyes p. 624

transitional cell carcinoma and p. 624

Bladder p. 649

transitional cell carcinoma p. 624

Cyclophosphamide p. 449

transitional cell carcinoma and p. 624

Hematuria p. 620

transitional cell carcinoma p. 624


transitional cell carcinoma p. 624

Ureter p. 603, 645, 649, 650

transitional cell carcinoma in p. 624


The most common form of cancer in the lower urinary tract—or the bladder and the urethra— is transitional cell carcinoma (or TCC), and to be more specific, urothelial cell carcinoma (or UCC).

While this cancer can affect tissues in the upper urinary tract, such as the renal pelvis and the ureter, it most commonly arises in the urothelium of the bladder.

The urothelium (or uroepithelium) is a specific type of transitional cell epithelium that lines the inner surface of much of the urinary tract. This tissue is composed of 3–7 cell layers, and it forms a tight barrier which holds urine without allowing toxins to move across the epithelium and back into the body.

That barrier function is largely accomplished by large umbrella cells that line the inner or luminal surface of the urothelium, and are held together by high resistance tight junctions, and are lined with a unique protein/lipid complex, called a plaque, along their apical membrane.

Now when you think about the bladder, it’s going to cyclically change shape during the course of its normal function.

For example, after you chug a tall mango lassi, your bladder will become completely filled up only to be emptied again when you rush to the restroom. Therefore, the urothelium has to be able to maintain its impermeable properties during these normal changes in bladder shape. Most of this is allowed for by the unfolding of the mucosal surface when the bladder fills up.

When the bladder is empty, this surface is highly wrinkled with rugae which then smooths out as the bladder becomes distended. In addition to this, these umbrella cells of the urothelium, have the ability to stretch with an expanding bladder. In fact, the term “transition” of transitional epithelium refers to this ability to go through transitions of shape.


Transitional cell carcinoma (TCC), also known as urothelial cell carcinoma, is a type of cancer that affects the transitional cells that line the bladder, ureters, and renal pelvis. It is the most common type of bladder cancer, and can cause symptoms such as blood in the urine, painful urination, frequent urination, and back or abdominal pain. TCC is typically treated with a combination of surgery, radiation therapy, chemotherapy, or immunotherapy, and the prognosis depends on the stage and location of the cancer, as well as the individual's overall health. Early diagnosis and treatment can improve the chances of recovery and long-term survival.


  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Incidence and Survival of urothelial carcinoma of the urinary bladder in Norway 1981-2014" BMC Cancer (2016)
  6. "Transitional cell carcinoma involving the prostate: a clinicopathological retrospective study of 76 cases" PubMed (undefined)
  7. "Dilemmas in the treatment of urothelial cancers of the prostate" Urologic Oncology: Seminars and Original Investigations (2009)

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