Bladder tumors

Bladder tumors are 1.5-3% of all tumors and 30% of all tumors of the urinary system. In men, they are observed in 3-4 times more often, what women. They most often appear in people over 40 years. Epithelial tumours account for 95% of all tumors of the bladder.
The etiology of urinary bladder tumors, and tumors of other organs, remains outstanding.
Specific etiological factor professional bladder tumors are derivatives of aniline - benzidine, alpha-naphtylamine, beta-naphtylamine, couples, which penetrate into organism through skin and the respiratory tract and are excreted by the kidneys in the form of hydrolyzed amines. The latter have carcinogenic effects on the epithelium of the urinary tract, causing its proliferation. Because urine containing carcinogenic amines, longest retained in the bladder, and their influence on the mucous membrane of the bubble is most expressed. This kind of "aniline tumors occur with long-term exposure to carcinogenic amines and meet the employees aniline industry or in persons who have regular contact with aniline dyes.
Sometimes (rarely) bladder tumors arise from prolonged irritation, for example in chronic cystitis, stone, ulcer.
Epithelial tumors of the bladder can be divided into three categories: 1) papilloma, 2) papillary cancer, 3) dense cancer.
A skin tag is a villous tumor structure on a thin stem that comes from mucosal and submucosal layer of the bladder. Thin NAP fan out like wood crown. The mucous membrane around the tumor is not changed. Histologically stroma legs and branches tumors are composed of fibrous cords from taking place in the center of his blood vessel. Stroma covered three epithelial layers - cylindrical, transitional and flat. The last one is external. Already in the early stages of papillary tumors have a tendency to colonization of the mucous membrane of the bubble and the recurrence after their removal, i.e. the features common malignant tumors.
Papillary cancer. Sooner or later "typical" papilloma trend of malignization and infiltrating increase in thickness of the wall of the bladder. Leg tumor becomes thicker and short NAP its thicken, mucous membrane around the base of the tumor becomes swollen, sometimes seen walking toward her vessels, compressed by the tumor. Histologically found atypical forms and polymorphism of cells, increased the number of cores, wrong mitoses.
The tumor grows muscular layer of the bladder, in appearance keeping papillary structure. Such tumors are called papillary cancer. Along with the growth of the tumor delves into the thickness of the wall, gradually losing their villous structure.
Dense cancer - fleshy, devoid CVS tumor, few outstanding in the lumen of the bubble. Around the tumor mucosa hyperemic, bolesno swollen. This tumor grows deep into the thickness of the gallbladder wall, often in kolapushinu tissue and gives metastases in regional lymph nodes, liver, lungs and bone. Histologically, it is a squamous cell, much less glandular cancer.
Thus, papilloma bladder is potentially malignant, in papillary cancer malignancy becomes obvious. Dense form of bladder cancer is the most malignant. It follows from the above that almost all of epithelial tumors of the bladder should be considered as malignant. They represent a single stage blastomycosis process.
On the instructions of the Ministry of health of the USSR bladder tumors are divided into 4 stages.
Stage I. Small limited tumor, not infiltrating the muscular layer of the bladder.
Stage II. Common tumor infiltration muscle layer.
Stage III. The tumor occupies half of the bladder, grows it and spaevaet with neighbouring authorities. The mouth of the ureters free. Metastases in lymph nodes.
Stage IV. The cancer has spread to the mouth of the ureters, sprouting nearby tissue and organs. Visible extensive local and remote metastases. Notes cachexia.
The sub-Committee of the International Union against cancer (UICC) proposed his own classification of tumors of the bladder under the name of "TNM". The letter T (tumor) indicated the presence of a tumor, and digital set-top box to it, such as T1, T2, and so on - depth infiltration. T1 means infiltration of the mucous membrane, T2 - the inner half of the muscular layer, T3 - just muscular layer, T4 - okolopostelnoy fiber. When lymph nodes are added the letter N (noduli), in the presence of metastases is the letter M for Example: T3N + M - the defeat of the muscle layer and lymph nodes with metastases.
The depth of germination tumor of the bladder wall determines the degree of malignancy her, clinical course and outcome. It follows from the peculiarities of impossibilia bladder. A rich and extensive lymph network bladder concentrated in the muscle layer and okolopostelnoy tissue. If the tumor spreading muscular layer, and the more okolopostelnoy tissue proliferation of tumor cells, i.e., metastasis, inevitably (Fig. 107).
The most common symptom of bladder tumors is hematuria, usually macro, rarely microscopic. The reason macrohematuria is a violation of the integrity of the vessel or the collapse of the tumor. In some cases, when heavy bleeding, the bubble is filled by blood clots, difficult urination, or cause of acute urinary retention. When infiltrating tumors hematuria less intense than in papillomas.
When mainfilterarea tumors hematuria suddenly appears and stops, without any disorders. In some cases, it is repeated often many years later, in other often.
The tumor is located near the mouth of the ureter, violate outflow of urine may cause a dull or sharp pain in the kidneys.
Interruption of the urine stream, difficulty urinating or full urinary retention observed in tumors located in the neck of a bubble.
Tumor infiltrating the wall of the bladder and involving in process of the nerves, causing pain, especially with the reduction of the bladder wall at the end of urination.
Gradually dysuria increasing, there are painful tenesmus, constant pain in the bladder. Dysuria is compounded by the almost inevitable accession of the infection to the disintegrating bladder cancer. Developing cystitis and pyelonephritis on the soil of the stagnation of urine in the compression of tumor infiltration mouths ureters.