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Morphologische und molekulare Charakteristika flacher Urothelveränderungen

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Urinzytologie

Zusammenfassung

Die Histomorphologie kennt seit langem »flache« Veränderungen des Urothels, die unter den Standardbedingungen der Zystoskopie (Weißlichtendoskopie) in einem gewissen Ausmaß der makroskopischen Entdeckung entgehen. Rezent wird deutlich, dass die Technik der Fluoreszenzendoskopie zu einer höheren Rate der Detektion dieser »flachen« Veränderungen führt (Zaak et al. 2002). Hier handelt sich um eine Methode, bei der sog. Photosensitizer oder deren Vorläufersubstanzen (z. B. 5-Aminolävulinsäure oder deren Esterderivate) in die Harnblase instilliert werden und innerhalb des Urothels zu einer selektiven Rotfluoreszenz von Tumoren wie auch von flachen Urothelregionen unter Blaulichtanregung führen (Zaak et al. 2005; Knüchel et al. 2003). Die Läsionen treten einzeln oder multifokal auf, werden aber auch im Kontext von manifesten Tumoren und Entzündungen in der Harnblase gefunden.

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Literatur

  • Am J Ind Med. 21: 877–885

    Google Scholar 

  • Denzinger S, Mohren K, Knuechel R, Wild PJ, Burger M, Wieland WF, Hartmann A, Stoehr R (2006) Improved clonality analysis of multifocal bladder tumors by combination of histopathologic organ mapping, loss of heterozygosity, fluorescence in situ hybridization, and p53 analyses. Hum Pathol. 37: 143–51

    Article  CAS  PubMed  Google Scholar 

  • Eble JN, Sauter G, Epstein JI, Sesterhenn IA (eds) (2004) World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs. IARC Press, Lyon

    Google Scholar 

  • Epstein JI, Amin MB, Reuter VR, Mostofi FK (1998). The World Health Organization/International Society of Urological Pathology consensus classification of urothelial (transitional cell) neo- plasms of the urinary bladder. Bladder Consensus Conference Committee. Am J Surg Pathol 22: 1435–1448

    Google Scholar 

  • Glatz K, Willi N, Glatz D, Barascud A, Grilli B, Merzog M, Dalquea P, Feichter G, Glasser TC, Sulser T, Bubendorf L (2006) An international telecytologic quiz on urinary cytology reveals – edicational deficits and absence of a commonly used classification system. Am J Pathol 126: 294–301

    Google Scholar 

  • Hafner C, Knuechel R, Zanardo L, Dietmaier W. Blaszyk H, Cheville J, Hofstaedter F, Hartmann A (2001) Evidence for oligoclonality and tumor spread by intraluminal seeding in multifocal urothelial carcinomas of the upper and lower urinary tract. Oncogene 20: 4910–4915

    Article  CAS  PubMed  Google Scholar 

  • Hartmann A, Moser K, Kriegmair M, Hofstetter A, Hofstaedter F, Knuechel R (1999) Frequent genetic alterations in simple urothelial hyperplasias of the bladder in patients with papillary urothelial carcinoma. Am J Pathol 154: 721–727

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Hartmann A, Schlake G, Zaak D, Hungerhuber E, Hofstetter A, Hofstaedter F, Knuechel R (2002) Occurence of chromosome 9 and p53 alterations in multifocal dysplasia and carcinoma in situ of urinary bladder. Cancer Res 216: 809–818

    Google Scholar 

  • Hofstaedter F, Delgado R Jakse G, Judmaier W (1986) Urothelial dyslasia and carcinoma in situ of the bladder Cancer 57: 356–361

    Article  Google Scholar 

  • Kim MS, Jeong J, Majewski T, Kram A, Yoon DS, Zhang RD, Li JZ, Ptaszynski K, Kuang TC, Zhou JH; Sathyanaryana UG, Tuziak T, Johnston DA, Grossman HB, Gaszdar AF, Scherer SE; Bedict WF, Czerniak B (2006) Evidence for alternative candidate genes near RB1 involved in clonal expansion of in situ urothelial neoplasia. Lab Invest 86: 175–90

    Article  CAS  PubMed  Google Scholar 

  • Knuechel R, Hartmann A, Stoehr R, Baumgartner R, Zaak D, Krieg RC. (2003) Precancerous conditions in the urothelium. Early detection and molecular understanding through endoscopic fluorescence diagnosis. Pathologe 24: 473–9

    Article  Google Scholar 

  • Koss LG (1988) Minimal neoplasia as a challenge for early cancer detection. Review.Recent Results Cancer Res 106: 1–8

    Article  CAS  PubMed  Google Scholar 

  • Koss LG Nakanishi I, Freed SZ (1977) Nonpapillary carcinoma in situ and atypical hyperplasia in cancerous bladders. Urology 9: 443–455

    Article  Google Scholar 

  • Koss LG, Tiamson EM, Robbins MA (1974) Mapping cancerous and precancerous bladder changes. A study of the urothelium in ten surgically removed bladders. JAMA 227: 281–6

    Article  CAS  PubMed  Google Scholar 

  • Melikow MM (1952) Histological study of vesical urothelium intervening between gross neoplasms in total cystectomy. J Urol 68: 261–279

    Google Scholar 

  • Mostofi FK, Davis CJ jr, Sesterhenn IA (1988) Pathology of tumors of the urinary tract. In: Steinner DG, Leikovsky G (eds) Diagnosis and Mangament of genito-urinary cancer. Saunders, Philadelphia

    Google Scholar 

  • Mostofi FK, Davis CJ, Sesterhenn IA (1999) World Health Organizsation International Histological classification of tumours. Histological typing of urinary bladder tumours. 2nd edition. Springer Verlag: Berlin Heidelberg

    Book  Google Scholar 

  • Murphy WM (2006) What´s the trouble with Cytology? J Urol 176: 2343–2346

    Article  PubMed  Google Scholar 

  • Obermann EC, Junker K, Stoehr R, Dietmaier W, Zaak D, Schubert J, Hofstaedter F, Knuechel R, Hartmann A (2003) Frequent genetic alterations in flat urothelial hyperplasias and concomitant papillary bladder cancer as detected by CGH, LOH, and FISH analyses. J Pathol 199: 50–7

    Article  CAS  PubMed  Google Scholar 

  • Stoehr R, Knuechel R, Boecker J, Blaszyk H, Schmitt R, Filbeck T, Hofstaedter F, Hartmann A (2002) Histologic-genetic mapping by allele-specific PCR reveals intraurothelial spread of p53 mutant tumor clones. Lab Invest 82: 1553–15

    Article  CAS  PubMed  Google Scholar 

  • Stoehr R, Zietz S, Burger M, Filbeck T, Denzinger S, Obermann E, Hammerschmied C, Wieland WF, Knuechel R, Hartmann A (2005) Deletions of chromosomes 9 and 8p in histologically normal urothelium of patients with bladder cancer. Eur Urol 47: 58–63

    Article  CAS  PubMed  Google Scholar 

  • Sylvester JR, Van Der Meyden A, Witjes JA, Jakse G, Nonomura N, Cheng C, Torres A, Watson R, Kurth KH (2005) High-grade Ta urothelial carcinoma and carcinoma in situ of the bladder. Urology 66 (suppl 6A): 90–107

    Article  PubMed  Google Scholar 

  • Taylor DC, Bhagavan BS, Larsen MP, Cox JA, Epstein JI (1996) Papillary urothelial hyperplasia. A precursor to papillary neoplasms. Am J Surg Pathol. 20: 1481–8

    Article  CAS  PubMed  Google Scholar 

  • Zaak D, Hungerhuber E, Schneede P, Stepp H, Frimberger D, Corvin S, Schmeller N, Kriegmair M, Hofstetter A, Knuechel R. (2002) Role of 5-aminolevulinic acid in the detection of urothelial premalignant lesions. Cancer 95: 1234–8

    Article  PubMed  Google Scholar 

  • Zaak D, Karl A, Knuechel R, Stepp H, Hartmann A, Reich O, Bachmann A, Siebels M, Popken G, Stief C (2005) Diagnosis of urothelial carcinoma of the bladder using fluorescence endoscopy. Review BJU Int. 96: 217–22

    Article  Google Scholar 

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Knüchel, R., Hofstädter, F., Lindemann-Docter, K. (2007). Morphologische und molekulare Charakteristika flacher Urothelveränderungen. In: Urinzytologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44779-6_5

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  • DOI: https://doi.org/10.1007/978-3-662-44779-6_5

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