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At least 127 records · Page 7Linked to original sources

Systemic anaplastic large cell lymphoma presenting as a bladder neoplasm.

Non-Hodgkin's lymphoma is known to involve the bladder, either primarily or secondary. Anaplastic large cell lymphoma has not been documented at this site before. We report a case of a systemic anaplastic cell lymphoma in a 22-year-old man who presented with multisystemic symptoms and signs, including those suggestive of bladder disease. He was HIV-negative. Biopsy of the bladder showed a high grade lymphoma composed of large cells with nuclei containing prominent nucleoli. The tumor cells expressed CD30, CD45, EMA and ALK-1. A diagnosis of anaplastic large cell lymphoma, of null cell phenotype was made. The lymph node biopsy showed similar features on hematoxylin and eosin section. The patient was put on a regime of CHOP and is disease-free 33 months after diagnosis.

Adult↗

[Preservation of potency by supra-ampullar cystectomy in patients with bladder neoplasms].

Between May 1984 and November 1998 a total of 27 consecutive patients with bladder tumor (26 transitional cell carcinomas and 1 leiomyosarcoma) underwent supra-ampullar cystectomy and ileal orthotopic neobladder (2 Camey I and 25 Camey II). Mean patients age was 51.1 years (range 23-65). Pre-operatively 22 patients had superficial bladder carcinoma. An involvement of prostatic urethra was excluded by biopsy. The bladder, part of the prostate with prostatic urethra and regional lymph nodes were removed while was deferens, deferential ampullae, seminal vesicles, ejaculatory ducts and peripheral portion of the prostate were saved. Mean follow-up was 56.5 months (range 4-178). One patient was lost to follow-up at 60 months. Of the 27 patients 6 died of bladder cancer (1 with local relapse, 1 with local and distant recurrence and 5 with metastases) and the remaining 21 had neither local nor distant relapse. Four patients died of other causes. Potency was preserved in 25 patients (92.5%) who reported satisfactory sexual intercourse. Sixteen patients (59.2%) also maintained ejaculation allowing procreation in two of them. Supra-ampullar cystectomy provides good results in term of quality of life allowing to preserve sexual function in nearly all the cases without compromise the control of the neoplastic disease. The indication must be restricted to bladder cancer without risk of local recurrence and concomitant prostatic carcinoma.

Adult↗

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↗

[Destruction of bladder neoplasms by means of transurethral neodym-YAG-laser coagulation].

Tumors of the urinary bladder were destroyed successfully by the use of a Neodymium-YAG-laser for the first time at the Department of Urology of the University of Munich. A final estimation of the real value of this method cannot be made because the number of cases was too small and the period of follow-up too short. Nevertheless we hope to increase the spectrum of transurethral treatment of bladder tumors. The use of the Neodymium-YAG-laser irradiation seems to make sense especially in treatment of tumors reaching deep layers of the bladder wall.

Carcinoma, Transitional Cell↗

[Choice of a method of surgical treatment of urinary bladder neoplasms].

The results of treatment of 850 patients with urinary bladder cancer (UBC) are analysed. Precise staging of the tumor should be made in the following order: suprapubic ultrasonic investigation (USI), cystoscopy and microcystoscopy, transrectal, transurethral USI. Indications for different treatments are outlined: typical and atypical papillary fibroepithelioma, papillary cancer in stage T1 should be managed with TUR after previous electrocoagulation; cancer in stage T2-3--with urinary bladder resection and uni- or bilateral pelvic lymphadenectomy; total papillomatosis, multiple lesions in stage T3, in cases of recurrent cancer--with cystectomy including one-stage or multistage replacement of the urinary bladder by intestinal transplant. The only physiologically sound method of treating patients after cystectomy with ureterocutaneostomy and ureterocolostomy is creation of intraperitoneal intestinal urinary bladder with reestablishment of transurethral urination. Arguments against creation of artificial urinary bladder made of detubularized segments consist in the absence of advantages.

Cystectomy↗

[Transurethral echography in the staging of bladder neoplasms].

Forty vesical neoplasias in various stages and which were treated through transurethral resection followed by chemotherapy, in accordance to the currently accepted approach, were studied using transurethral ultrasound techniques. A histochemical correlation is established based on the proposed U.I.C.C. grading (T.N.M.). Such correlation coincides in 88.2% of cases for the "unified" Ta-T1 stage; 70% for T2; 88.8% for T3; and 100% for T4.

Adult↗

[The characteristics of the hormonal status in women with bladder neoplasms].

In a controlled trial a gynecological history has been studied for 154 females with bladder tumors against 213 matched women without the tumor. The risk to develop the tumor was found to rise with the history of a short reproductive period, abortions, primary infertility, cancer of the corpus uteri and of the breast, ovarian cysts. Tryptophan metabolism assessed in 242 and 541 women and men with bladder cancer and free of it, respectively, was indicative of more frequent urinary registration of carcinogenic tryptophan metabolite 3-oxyantranilic acid: for females 40.5 per 100 in case of cancer, 10 per 100 in healthy ones; for males with cancer 33.9, without cancer 7.4 per 100 examinees. Radioimmunoassays of hormone concentrations in the serum with correlation to tryptophan metabolism for 55 cancer and 49 healthy females showed lowered levels of progesterone, folitropin and lutropine to occur more often in cancer women with urinary 3-oxyantranilic acid. The above endogenic factors analyzed retrospectively suggest involvement of hormonal status alterations in bladder cancer onset.

Adult↗

Chromosome changes in early bladder neoplasms.

There are few cytogenetic studies of early (non-invasive) bladder cancer, particularly in situ carcinoma, due to technical difficulties in examining such lesions. The best approach is to extrapolate from chromosomal changes in more advanced cancers. Although no specific chromosomal changes have been established in either early or fully developed bladder cancers, certain recurrent anomalies have been encountered. Anomalies such as +1, +7, -9, 5q- or i(5p), 11p- and -Y appear to constitute part of the multistep carcinogenetic process by which clinically and pathologically recognizable bladder cancers develop. Since loss of part or all of chromosome 9 (-9) is a common and early cytogenetic event in bladder cancer, the detection of -9 in bladder washings or urine by fluorescence in situ hybridization (FISH) may be a promising test for early or recurrent bladder cancer. Although less frequent than -9, trisomy 7 (+7) is common enough to serve a similar purpose. In contrast, loss of the Y chromosome may indicate an advanced stage of bladder cancer. Thus, FISH studies utilizing probes for chromosomes 7, 9, and Y should yield cogent information to identify early bladder cancer. Cytogenetic (including FISH) studies combined with certain molecular approaches (e.g., p53 mutations detected immunochemically) may not only serve to differentiate early cancer from benign tumors or conditions, but may also help establish cancer stage. This would supply data of considerable usefulness to the clinician and pathologist.

Chromosome Aberrations↗

[Clinico-pathologic differences between bladder neoplasm with low malignant potential and low-grade carcinoma].

OBJECTIVE: To determine if the morphologic subgrouping of grade I bladder tumors between papillary neoplasm of low malignant potential and low grade papillary carcinoma is of clinical and survival value. MATERIAL AND METHODS: All 257 consecutive patients diagnosed of superficial bladder cancer between 1990 and 1995 in HU Reina Sofia of Cordoba were reviewed and further reclassified according to WHO/ISUP consensus classification of urothelial neoplasms of the bladder. Of the tumors 12 were urothelial papilloma, 51 were papillary neoplasm of low malignant potential, 43 were low grade papillary carcinoma Ta, 65 were low grade papillary carcinoma T1 and 37 were high grade papillary carcinoma. Eleven patients were reevaluated as T2 tumors and 38 (14.8%) were lost of control. All patients were reviewed with a follow-up at least of 5 years. We compare the results between groups with Fisher test and the risk factors for recurrence and progression are analyzed by multivariate analysis (Odds ratio). The survival function was calculated using Kaplan-Meier estimates and compared with the log-rank test. RESULTS: There are no differences between groups respect the age or sex distribution. The differences in the multiplicity are not significant and only the mean size is higher in papillary low grade carcinoma. About the risk factors for recurrence and progression of the disease, only is significative the tumor size. Rarely, the use of chemotherapy seems to play a role in the recurrence. There are no differences in recurrence and progression between the groups, although the percentages are always higher in the papillary low grade carcinoma group. CONCLUSIONS: There are enough clinical differences between the two groups and we consider them as distinct pathologic entities. Only the higher tumoral size is prognostic factor in each group. We think that the use of chemotherapy must be avoided in this low grade bladder tumors.

Carcinoma↗