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At least 19 recordsLinked to original sources
PubMed2005

The role of immunohistochemistry in the diagnosis of urinary bladder neoplasms.

The spectrum of neoplasms involving the urinary bladder is diverse, and, at times, different entities with distinct prognostic and managerial implications may have significant morphologic overlap. The presence of a neoplasm with an unusual morphologic appearance, such as an undifferentiated spindled, or plasmacytoid pattern may necessitate immunohistochemistry to establish the diagnosis. In this review, we discuss a series of distinct diagnostic scenarios, including high-grade undifferentiated carcinoma versus prostatic adenocarcinoma, enteric-type adenocarcinoma versus secondary colorectal adenocarcinoma, spindle cell proliferations, neoplasms with plasmacytoid morphology, endophytic tumors with a nested growth pattern, and flat urothelial lesions with atypia. We also discuss markers supporting urothelial differentiation in the context of a metastatic carcinoma from an unknown primary. The importance of using a morphologically derived differential diagnosis to guide the selection and interpretation of immunohistochemical studies is emphasized, and the varying utility (specificity) of the individual immunohistochemical markers within each setting is addressed.

Adenocarcinoma↗
PubMedDate not supplied

Staging of urinary bladder neoplasms with MR imaging: is Gd-DTPA helpful?

This study was performed to investigate whether intravenous administration of Gd-DTPA can improve the accuracy of MR imaging in the detection and staging of bladder neoplasms. In 68 patients with suspected urinary bladder neoplasms, MR examinations were performed with T1-weighted SE sequences before and after intravenous administration of Gd-DTPA. The findings were compared with surgical staging using the TNM classification. Overall staging accuracy of contrast enhanced MR was 46%; if stages Ta-T3a were combined into one group, the accuracy was 69%. Accuracy was low (19%) in tumors without muscular bladder wall invasion (Ta). In cases with extravesical spread (greater than or equal to T3b), the accuracy of staging was 87%. Contrast enhanced MR detected extravesical extension of tumor with a sensitivity of 93% and a specificity of 95%. Contrast enhancement increased the sensitivity for detection of urinary bladder neoplasms from 70% on precontrast T1-weighted scans to 79% on postcontrast scans. In comparison with T2-weighted scans, the Gd-DTPA enhanced T1-weighted scans had better image quality and lower acquisition times.

Adult↗
PubMedDate not supplied

[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↗
PubMed1989

Urinary bladder neoplasms: evaluation with contrast-enhanced MR imaging.

Forty-eight patients with urinary bladder neoplasms were examined with magnetic resonance imaging before and after intravenous administration of gadolinium diethylene-triaminepentaacetic acid (DTPA). Spin-echo sequences with short repetition and echo times were used in all patients; in 20 a gradient-echo technique was used to perform sequential imaging. In 31 patients ratios of tumor signal intensity to that of fat, muscle, and bone marrow were calculated before and after Gd-DTPA enhancement on T1-weighted spin-echo images. Increases in tumor signal intensity on T1-weighted spin-echo images were statistically significant after contrast enhancement (alpha = 1%, P less than .0001). The average rise in relative signal intensity after contrast enhancement was 120% for the tumor-fat ratio (tumor-marrow ratio, 105%; tumor-muscle ratio, 85%). Tumor signal intensity peaked within 120 seconds and remained on a plateau for up to 45 minutes. Necrotic tissue within the tumor, seen in three cases, was detectable only on contrast-enhanced images.

Adult↗
PubMed1985

[Value of nuclear magnetic resonance tomography in the diagnosis and stage determination of urinary bladder neoplasms].

We arrived at the following conclusions in our study on the ranking of magnetic resonance tomography in diagnosis and staging of urinary bladder neoplasms: MR tomography possesses high sensitivity but only low specificity in diagnosing the local spread of the tumour. Sensitivity of MR seems to be better in respect of determining the paravesical tumorous spread, than that of other methods. However, it is not possible to determine the tumour status of a space-occupying growth. No advantages of MR over other methods, especially computed tomography, were seen in the examination of lymph node metastases in the minor pelvis.

Humans↗
PubMedDate not supplied

MR imaging of urinary bladder neoplasms.

The diagnostic potential of magnetic resonance (MR) imaging at 1.5 T for assessment and staging of urinary bladder tumors was investigated in 10 patients with malignant urinary bladder tumors. All patients underwent complete pathologic staging. The appearance of the urinary bladder tumors and the ability to stage them by means of MR imaging was evaluated morphologically and compared with results obtained with pathologic examination. Magnetic resonance imaging permitted tumor localization in all patients. In nine patients the tumor stage was accurately determined by MR imaging. The smallest tumor detected by MR imaging was 1.5 cm. Both transverse and sagittal imaging planes were found to be essential for accurate assessment of tumor extension. Signal intensity data obtained from both dual and multi spin echo sequences showed that tumor display and depth of infiltration was best seen with a repetition time (TR) of 2,000 ms and an echo time (TE) of 90 ms. Accurate evaluation of perivesical tumor infiltration required a sequence with a TR 800 ms and a TE 30 ms. Data presented here further support the role of MR in staging urinary bladder neoplasms.

Aged↗
PubMedDate not supplied

Urinary bladder neoplasms induced in BALB/c female mice with low doses of 2-acetylaminofluorene.

Large numbers of female BALB/c mice were exposed to low levels of 2-acetylaminofluorene (2-AAF) in the diet. The dose response for urinary bladder neoplasms exhibited a shallow trend to low doses which increased sharply at the higher doses. The dose response over the entire dosage range gave the impression of a "threshold" type response below the mid-doses. Since the tumor incidence at the lower doses was less than 1.0 percent, relatively few urinary bladder tumors occurred. Thus, it was deemed advisable to re-examine noninvasive or early invasive bladder carcinomas and to study the dose response for only the "unequivocal" urinary bladder tumors. Examination of the dose response curves for "unequivocal" urinary bladder tumors showed a positive trend over the low end of the dose range. As a further check, an analysis was conducted on only invasive or metastasizing bladder carcinomas. In this case, there was no significant low dose trend. Thus, the shape of the low dose response curve for bladder carcinomas remains uncertain.

2-Acetylaminofluorene↗
PubMed2003

A population-based study of 538 patients with newly detected urinary bladder neoplasms followed during 5 years.

OBJECTIVE: To describe in detail the diagnosis and clinical course of an unselected population-based cohort of patients with newly diagnosed bladder neoplasms. MATERIAL AND METHODS: A total of 538 patients registered in the Stockholm region with newly diagnosed primary bladder neoplasms (transitional cell carcinomas) in 1995 and 1996 were followed for at least 5 years. All hospitals and urology units in the region participated in the study. Treatment and follow-up were performed according to a standard-of-care programme. Routine pathological reports were used. Original case records were scrutinized on location in 2001. In addition, a tumour bank of freshly frozen tumour tissue was established. RESULTS: The calculated 5-year cancer-specific survival rate for the 538 patients in the cohort was 78%. No patient (0/29) with TaG1 tumours showed progression or died of bladder cancer. Only 2/187 patients (1%) with stage Ta and grade 2A or 2B tumours died of bladder cancer. In contrast, after 5 years of follow-up, patients with TaG3 and T1G2B tumours had disease-specific death rates of 20% and 27%, respectively. The result of the first cystoscopy examination after the initial resection of non-invasive tumours was of prognostic value. Recurrent disease was present in 62% (248/402) of all patients with Ta and T1 tumours at diagnosis and patients with T1 tumours had recurrences earlier than those with Ta tumours. Moreover, 32% (35/110) of the patients who presented with T1 tumours at diagnosis progressed to muscle-invasive disease during the follow-up period. The overall prognosis for patients presenting with muscle-invasive tumours (T2+) was dismal, with 69% (80/116) of the patients dying of the disease. CONCLUSIONS: We analysed a population-based cohort of patients with urinary bladder neoplasms in order to establish a clearly defined and unselected clinical series, with the main aims of comparing and evaluating the clinical utility of new molecular biology techniques. In the present series, TaG1 tumours behaved benignly. The disease-specific mortality rate was low for initial TaG2 tumours, intermediate for initial TaG3 and T1 tumours and high for initial T2+ tumours.

Adult↗
PubMed2004

Computed tomographic virtual cystoscopy for the detection of urinary bladder neoplasms.

OBJECTIVE: To evaluate the role of computed tomographic virtual cystoscopy (CTVC) in the detection of bladder neoplasms and to compare CTVC at conventional and reduced milliAmperes-second (mAs) settings. METHODS: Twenty-four patients with known bladder neoplasms from previous conventional cystoscopy were examined with CTVC. The urinary bladder was insufflated with room air and helical CT data were obtained. Virtual images were created using volume rendering algorithms. In eight patients we used both regular (240) and reduced (70) mAs values. The lesions were recorded on transverse tomographic slices and virtual images and compared with conventional cystoscopy, operative and pathology results. RESULTS: All bladder lesions (30) seen on conventional cystoscopy were demonstrated with CTVC. Two lesions detected on imaging studies and subsequently found at operation were not seen on conventional cystoscopy. In a third case of a neobladder, conventional cystoscopy was impossible due to neoplastic involvement of the penis. In all cases the lesions were equally conspicuous with conventional and low mAs values. CONCLUSIONS: Computed tomographic virtual cystoscopy is a minimally invasive technique that can provide comprehensive information about urinary bladder tumors. Furthermore, low mAs studies are equally effective for the examination of such patients.

Aged↗
PubMed1980

Biologic and morphologic characteristics of urinary bladder neoplasms induced in BALB/c female mice with 2-acetylaminofluorene.

2-Acetylaminofluorene (2-AAF) induced transitional cell carcinomas, transitional cell carcinomas with squamous metaplasia, squamous cell carcinomas and undifferentiated carcinomas in the urinary bladders of BALB/c female mice. The transitional cell carcinoma was the most common, but was less aggressive and infiltrative than the other three types. The carcinomas were most likely to occur in the vertex of the bladder. A positive correlation existed between dose and length of administration of 2-AAF and the incidence, type, depth of invasion, and the location of the bladder carcinoma.

2-Acetylaminofluorene↗
PubMed1990

Gadolinium-enhanced magnetic resonance imaging in the staging of urinary bladder neoplasms.

Magnetic resonance imaging (MRI) proved to be an important diagnostic tool in the correct staging of bladder neoplasms. The advantage of multiplane imaging and high soft-tissue contrast may be extended by the use of MRI contrast media such as the gadoliniumdiethylene-triaminepentaacetic acid complex. In 60 patients with suspected or proved bladder tumors, the results of preoperative gadolinium-enhanced MRI were correlated with the histopathologic findings. The staging accuracy of infiltrating tumors was 83% and sensitivity and specificity 86% and 83%, respectively. Three tumors could only be localized after administration of gadolinium. All active tumors demonstrated significant contrast enhancement after intravenously injected gadolinium. Small papillary tumors or carcinoma in situ remain problematic to preoperative staging procedures. The advantages of gadolinium-enhanced MRI will best be employed in the exact pretherapeutic staging of infiltrative bladder neoplasms or in restaging procedures after chemotherapy and radiotherapy.

Adenocarcinoma↗