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Stephan L. Werner, M.D., F.A.C.S. The bladder wall has 4 layers, the lining consists of so called transitional cells which line the entire urinary tract, and are the most common source of bladder cancer. The thin dividing layer between the lining and the muscle is called the lamina propria. Beyond that is the muscularis, the muscle layer and finally the adventitia, which separates the bladder from other organs. Over 90% of bladder cancers arise from the transitional layer and are called transitional cell carcinoma or TCC. The other bladder cancers, sarcomas, adenocarcinomas and squamous and small cell carcinomas arise from other tissues. will not be discussed on this website. Rarely tumors from other organs may metastasize or invade the bladder. These uncommon tumors will not be discussed. There are several varieties of TCC. Papillary TCC is the most common type. It appears as a series of fronds, or fingers, frequently on a stalk, waving in the lumen of the bladder, much as a sea anemone in a fish tank, or on a reef. Sessile TCC, a flat tumor looking like a mushroom cap or mud pie sitting on the bladder wall.. Carcinoma-in-situ or CIS, is a flat almost invisible cancer that usually is found only on biopsy. Grading: There are several grading methods. In general the lower the grade the more optimistic the outlook. Stage: TMN system, (Tumor Nodes Metastases), system is usually used. T0 No tumor present Tis Carcinoma-in-situ Ta Papillary tumor limited to lining (mucosa) T1 Tumor invades into but not through lamina propria T2 Tumor invades superficial muscle T3a Tumor invades deep muscle T3b Tumor invades fat outside of bladder T4a Tumor invades adjacent organ, (rectum, vagina, uterus) T4b Tumor involves pelvic or abdominal wall N0 No lymph nodes positive N 1-4 Tumor involves progressively distant lymph nodes M 0 No distant metastases M1 Distant Metastases
Rev: 02/02
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[Home] Werner - Francis Urology Associates llc - Mid Atlantic Urology Associates llc Greenbelt - Bowie - Laurel Maryland (301) 441-8900 Fax (301) 982 0453 7500 Hanover Parkway Suite 206 Greenbelt, MD 20770
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