Medical PPT/Urology

오예스좋아 2013. 2. 10. 03:06



Vesical Leukoplakia.ppt



방광 백반증 (방광 백판증) 에 대한 자료 입니다. 방광의 백반증은 이전에는 Premalignant 병변으로 구분되었지만 2006년 Staack 등이 Vesical leukoplakia 에서는 Tumor suppressor gene인 TP53 의 돌연변이가 결여되어있다는 사실을 밝힌 이후, 현재 전암 병변으로 구분되지 않고 암전이 가능성이 낮은 양성 종양으로 구분되고 있습니다.


과거와는 이러한 점이 다르니 참고 하셨으면 합니다.

그리고 이전 글인 Epithelial metaplasia 중에서 Keratinizing squamous metaplasia 와 이글의 Leukoplakia 는 같은 용어 입니다.


임상적으로 Cystoscopy상에서 방광이 백판으로 보이는 현상 때문에 임상에서는 Leukoplakia라고 하며, 병리조직학적으로는 Keratin 이 표면에 두껍게 침착된 편평세포 조직으로 화생되어 보이기 때문에 Keratinizing squamous metaplasia라는 용어를 사용합니다. 혼동이 없으면 합니다.


이번에도 발표용 PPT와 함께 올려 두겠습니다.




Leukoplakia of the Bladder (Vesical Leukoplakia)


  Leukoplakia is a clinical term indicating "white plaque."


  And also, leukoplakia is the clinical manifestation of histologically described keratinizing squamous metaplasia.

  Leukoplakia is known to occur in the mucous membranes of the body, including those of the urinary tract, rectum, vagina, uterus, vulva, paranasal sinuses, gallbladder, esophagus, eardrums, and pharynx.


  Currently, the clinical term "leukoplakia" is thought to be synonymous with the histopathologic diagnosis of keratinizing squamous metaplasia.

  It is distinctly different from estrogen-associated squamous metaplasia of the female trigone. (Nonkeratinizing squamous metaplasia)


  Metaplastic changes of the urothelium are associated with chronic inflammation, diverticuli, or stones and should not be confused with squamatization of the trigone (nonkeratinizing glycogenated squamous epithelium), which is a common occurrence in women during estrogen production.

  Hormone-associated squamatization of the trigone demonstrates no keratinization, intercellular bridges, or cellular atypia and is considered a normal anatomic variant.

  - Similar to squamous metaplasia with the addition of keratin deposition that appears as a white flaky substance floating in the bladder (Staack et al, 2006). 
  - Leukoplakia occurs in other organs that are covered by squamous epithelium and is often premalignant
    However, cytogenetic studies on bladder leukoplakia are consistent with a benign lesion, and no treatment is necessary (Staack et al, 2006).







 1. Campbell Urology

  Chapter 80 : Urothelial Tumors of the Bladder


 2. Staack A, Schlechte H, Sachs M, et al. Clinical value of vesical leukoplakia and evaluation of the neoplastic risk by mutation analyses of the tumor suppressor gene TP53. Int J Urol 2006;13(8):1092–7.


Vesical Leukoplakia.ppt


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Vesical Leukoplakia.ppt