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Urinary bladder neoplasms in Syrian hamsters after administration of N-nitroso-N-methyl-N-dodecylamine.

The biological effect of N-nitroso-N-methyl-N-dodecylamine (NMDA) was examined in Syrian hamsters as part of a comparative study. Data obtained show that after intragastric administration of NMDA, the urinary bladder was the main target organ for the carcinogenic effect. Transitional cell neoplasms developed and a positive dose response relationship was observed. Lung tumors occurred only in female hamsters, whereas males more frequently showed neoplasms of the nasal cavity and digestive tract.

Amines↗

Expression of UPA and UPAR is associated with the clinical course of urinary bladder neoplasms.

The expression of urokinase plasminogen activator (uPA) and its receptor (uPAR) mRNA was determined in 194 subjects with newly detected bladder neoplasms, selected from a larger population-based series. An association was found between uPA and uPAR expression (n = 172; Spearman r(s) = 0.60, p < 0.001). Both uPA and uPAR mRNA levels were higher in muscle invasive (T2+) tumors than in noninvasive mucosal tumors (Ta) or those invading submucosa (T1). The relative hazard ratios (RHRs) for cancer-specific death associated with elevated expression (95% CI), adjusted for age and gender in a Cox proportional hazard model, were 1.8 (1.0-3.3) for uPA (upper quartile cut-line), 2.2 (1.3-4.0) for uPAR (median quartile cut-line) and 2.5 (1.3-4.9) for uPA + uPAR. An RHR for metastatic disease of 4.0 (1.6-9.9) was observed for uPAR. Restricting the analyses to T2+ tumors, the corresponding figures were: 2.1 (1.1-3.9) for uPA, 1.6 (0.8-3.3) for uPAR and 2.5 (1.1-5.6) for both. We conclude that expression of uPA and uPAR is associated with the clinical behaviour of bladder neoplasms, possibly providing means for refined staging of muscle invasive tumors and target proteins for novel therapies.

Gene Expression↗

Abscess of urachal remnant mimicking urinary bladder neoplasm.

Three cases of urachal abscess with extensive interstitial inflammation and fibrosis are reported. Clinically, all patients had a lower abdominal mass and CT scan and ultrasonic examination revealed a large tumour located anterior or superior to the bladder. They all underwent laparotomy and had either a partial cystectomy or an en bloc resection of the bladder and adjacent organs due to severe adhesions. Microscopic examination of the specimens revealed no evidence of carcinoma and only abscess formation with extensive chronic interstitial inflammation and fibrosis were seen. In one case, residual columnar epithelium suggestive of urachal origin was identified in the abscess cavity. Urachal abscess should be considered when dealing with lower abdominal masses.

Abscess↗

Cytohistological study of urinary bladder neoplasms.

Eighty patients presenting with painless hematuria and 24 patients of transitional cell carcinoma bladder coming for follow up were included in this study to assess the role of exfoliative (voided urine) and lavage (saline lavage) cytology in initial diagnosis and follow up of the patient with carcinoma bladder. Freshly voided urine samples and saline lavage bladder washing samples were collected. A thorough cystoscopic examination was done and biopsy was taken from any apparent growth. Cytological smears were stained with hematoxylene and eosin and PAP's stain, histology sections were stained with hematoxylene and eosin. A statistically significant correlation (p < 0.001) was observed between the increasing grade of malignancy and cytopositivity. A good association was observed between histology and two methods of cytology (p < 0.01). The sensitivity, specificity and overall diagnostic accuracy of lavage cytology was more as compared to exfoliative cytology (71.05%, 56.0%, 78.85% Vs 47.37%, 41.18% and 61.54%). Cystopositivity was more with single large sessile tumour as compared to multiple small pedunculated tumours. Cytohistological discrepancy was observed in patients of transitional cell carcinoma with recurrence. It is concluded that cytology may act as a good adjuvant to histology in picking up early flat lesions and/or follow up of patients with transitional cell carcinoma.

Carcinoma, Transitional Cell↗

Significance of variations in section mounting technique for nuclear stereology and morphology in urinary bladder neoplasms.

Owing to its toxicity it would be desirable to avoid xylene in the processing of histological tissue. Consequently, modifications of the section mounting technique excluding xylene have recently been suggested. Changes in tissue preparation might, however, influence histopathological structures used for malignancy grading of tumours. In the current study, we investigated the impact of alterations in the mounting process on the subjectively evaluated quality of nuclear morphology and on the stereologically obtained mean nuclear volume, vv(nuc), of urothelial neoplasms. Paraffin sections from 14 tumours were, after the haematoxylin-eosin staining, mounted with DPX and a coverslip either, 1) from the water bath, 2) after dehydration in ethanol but without clearing, or, 3) after dehydration and xylene clearing. We found that the nuclear morphology of ethanol-treated and xylene-cleared specimens was somewhat more brilliant than that of sections mounted from water. The vv(nuc) of xylene-cleared sections ranged from 142 to 751 microns3, and the mean value of 350 microns3 was not significantly different from that of ethanol-treated sections of 367 microns3 (2p = 0.67). In contrast, the mean vv(nuc) of sections mounted from water was 459 microns3, approximately 30% larger (2p < or = 0.02). Thus, although previous studies have demonstrated the prognostic value of vv(nuc) in patients with bladder cancer, the present study shows that modifications in section mounting technique may significantly influence the results, underscoring the need for standardization of tissue processing. Sections mounted from ethanol seem to be as good as routine xylene-cleared sections, whereas sections mounted from water have a less brilliant morphology and results of nuclear stereology different from those of routine sections.

Cell Nucleus↗

Lymphoma affecting the urinary bladder in three dogs and a cat.

Three dogs and one cat with lymphoma affecting the urinary bladder are reported and the findings on abdominal radiographs and ultrasound are described. Mural lesions representing lymphoma affecting the urinary bladder were identified ultrasonographically in all animals. The most common complications associated with urinary bladder lymphoma were hydronephrosis and hydroureter. In two patients contrast radiography was necessary to detect leakage of urine in the peritoneal and retroperitoneal space. The radiographic and ultrasonographic signs were similar to those reported with other urinary bladder neoplasms; hence urinary bladder lymphoma could not be distinguished from the more common urinary bladder neoplasms, such as transitional cell carcinoma. It is important to include lymphoma in the differential diagnosis of urinary bladder wall thickening and mural mass in dogs and cats.

Animals↗

A single-nucleotide polymorphism in the XPG gene, and tumour stage, grade, and clinical course in patients with nonmuscle-invasive neoplasms of the urinary bladder.

OBJECTIVE: To evaluate whether the single nucleotide polymorphism (SNP), Asp1104His (G3507C), in the XPG gene affects malignant phenotypes of nonmuscle-invasive urinary bladder neoplasms (NIBN), by investigating associations between the SNP and clinicopathological variables in patients with NIBN. PATIENTS AND METHODS: The 233 patients constituted newly diagnosed cases of primary NIBN in the Stockholm area. The Asp1104His polymorphism in the XPG gene was genotyped using a polymerase chain reaction-restriction fragment length polymorphism technique. RESULTS: The GC + CC genotypes were more frequent in stage pT1 tumours at initial diagnosis than pTa (odds ratio 1.9, 95% confidence interval 1.0-3.5, P = 0.048). The difference was larger in the young group (4.6, 1.9-11.8, P = 0.001). In the young group, the GC + CC genotypes were significantly more frequent in high-grade than in low-grade tumours (3.1, 1.5-6.8, P = 0.004) whereas in the older group the genotypes were less frequent in high-grade tumours (0.3, 0.1-0.7, P = 0.007). The XPG genotypes were not associated with tumour recurrence, stage progression or survival. CONCLUSION: These results suggest that the SNP in the XPG gene might be related to tumour invasiveness in NIBN.

Adult↗

Chromosomal imbalances in noninvasive papillary bladder neoplasms (pTa).

Almost 70% of urinary bladder neoplasms present as low-grade papillary noninvasive tumors (stage pTa). To determine which genomic alterations can occur in pTa tumors of different grades and to evaluate the prognostic significance of chromosomal imbalances, we analyzed 113 pTa tumors (40 grade 1, 55 grade 2, 18 grade 3) by comparative genomic hybridization. pTaG1 (1.9 +/- 2.0) and pTaG2 (3.1 +/- 2.9) tumors had only few genomic alterations with 9q- (44%), 9p- (36%), and -Y (21%) being most prevalent. Neither the total number of aberrations nor any individual alteration was linked to the risk of recurrence in 95 pTaG1/G2 tumors with clinical follow-up information. pTaG3 tumors were characterized by a high number of alterations (7.7 +/- 4.5; P < 0.0001 for G3 versus G2). Several chromosomal imbalances that have previously been reported to be typical for invasive bladder neoplasms were significantly more frequent in pTaG3 than in pTaG2 tumors, including 2q-, 5p+, 5q-, 6q-, 8p-, 10q-, 18q-, and 20q+. A malfunction of genes at these loci may contribute to the development of high-grade urothelial neoplasias. However, there is no evidence for a direct role of these alterations for development of invasive tumor growth.

Carcinoma in Situ↗