By Renee Dintzis, Jennifer McBride (auth.), Donna E. Hansel, Jesse K. McKenney, Andrew J. Stephenson, Sam S. Chang (eds.)
Providing a real integration of pathology with scientific administration, this quantity offers a pragmatic, finished textual content on benign and malignant ailment of the grownup bladder. Integrating pathology, surgical administration, oncology and molecular learn in a site-specific demeanour to incorporate the urethra, urinary bladder, ureter and renal pelvis, The Urinary Tract: A entire consultant to sufferer prognosis and administration is the 1st textual content in grownup bladder disorder to heavily interweave a number of medical disciplines into every one bankruptcy. for almost all of chapters, a pathologist and urologist or urologic oncologist are paired to supply the best integration of data for every illness process.
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Additional resources for The Urinary Tract: A Comprehensive Guide to Patient Diagnosis and Management
The thick ascending limb is one of the most important loop structures that maintain the salt gradient in the medulla; it performs this function by actively pumping NaCl out of the tubule and into the medullary interstitium. The cells in the wall of the ascending thick limb are impermeable to water, so the contents become hypotonic as salt is pumped out of the tubule. As in the proximal tubule cells, mitochondria in the thick ascending limb cells are abundant to supply energy for ion pumping. As the thick ascending limb returns to the cortex, it makes contact with the vascular pole of the “parent” renal corpuscle from which the tubules originated, to form the macula densa.
A stromal reaction may or may not be associated. On the contrary, von Brunn nests, even when proliferative, tend to be superficial to an imaginary line within the lamina propria, beyond which no nests are seen. Volmar et al. . studied a series of florid von Brunn nests cases and compared them to cases of nested urothelial carcinoma. No significant differences in the expression of p53, p27, or cytokeratin 20 could be found to differentiate between the two entities. Although nested urothelial carcinomas had a higher MIB-1 expression, no specific cutoff value could be determined for diagnostic purposes.
Also present within this layer of the blad- 23 der wall are blood vessels, lymphatics, nerve fibers, and fat cells. Due to the slightly irregular boundaries of the muscularis propria, the transition to the perivesical fat is often poorly defined, with low magnification assessment often required to distinguish carcinomas invading beyond this plane. In males, the muscularis propria merges with the prostatic fibromuscular tissue. Finally, the outermost layer of the bladder wall consists of either a serosa or adventitia, depending upon the location as described previously.