What are the pathologies of bladder cancer

In recent years, bladder cancer has become one of the major diseases that endangers society and human health, and it has brought great pain and distress to humans. In order to reduce the incidence of bladder cancer, we humans should master the pathology of bladder cancer:

1. Tumors arising from epithelial tissue mainly include transitional epithelial tumors, adenocarcinomas and squamous cell carcinomas. 98% of bladder tumors originate from epithelial tissue, of which transitional epithelial tumors account for 95%.

(1) Transitional epithelial tumors: mainly include carcinoma in situ, papilloma, papillary carcinoma and solid carcinoma. The latter two can appear in the same tumor at the same time, which is called papillary solid carcinoma. This classification is convenient for clinical application, but from the perspective of tumor biological behavior, whether they are continuous development of different stages of a disease or appear independently at the beginning is a controversial issue.

a. Carcinoma in situ is a special transitional epithelial tumor. It is initially confined to the transitional epithelium, forming slightly raised villous red pieces that do not invade the basement membrane. However, the cells are poorly differentiated and lose adhesion between cells, so the cells are easy to fall off and can be easily examined in the urine. The natural course of carcinoma in situ is difficult to predict. Some are asymptomatic for a long time and do not infiltrate, while others develop very quickly. It usually takes 1 to 5 years for carcinoma in situ to develop into invasive cancer, and sometimes it takes up to 20 years. Therefore, some people believe that there are two forms of carcinoma in situ, one of which represents the predecessor of solid cancer with invasive ability, and the other has no invasive ability, called paradoxical cancer, which is relatively benign.

b. Papilloma is a benign tumor. Histologically, it can be seen that the tumor originates from the normal bladder mucosa and protrudes into the bladder like waterweed. It has a slender pedicle, in which clear fibrous tissue and central bundles of blood vessels can be seen. Papilloma has the characteristic of recurrence, with a recurrence rate of 60% within 5 years, of which 48.6% relapse more than twice. Regular cystoscopic follow-up is necessary after surgery.

c. Papillary carcinoma is the most common type of transitional epithelial tumor. The pathological characteristics are that the papillae are short and fused, the tumor surface is not smooth, necrosis or calcium salts are deposited, the tumor base is wide or the pedicle is short and thick. Sometimes papillary carcinoma may be as long as a small fist, but still retains a pedicle and does not infiltrate other parts. Although this type is rare, it should be paid attention to to avoid unnecessary total cystectomy.

d. Solid carcinoma is the most malignant among transitional epithelial tumors. It has an uneven surface and no obvious papillary formation. There are ulcers on the surface of the tumor with raised edges and a nodular surface. It infiltrates deep into the tumor in the early stage, so it is also called invasive carcinoma.

The above is the pathology of bladder cancer. Expert Tip: If you have symptoms of disease, do not delay diagnosis and go to a regular hospital for treatment in time to avoid delaying the disease and causing serious consequences. If you have other questions, please consult our online experts or call for consultation.

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