12. Anatomy of the Urinary Bladder Revisited: Implications for Diagnosis and Staging of Bladder Cancer
Author: Prof. Victor E. Reuter
Publisher: Springer New York
The anatomy of the urinary bladder is complex. Surface urothelium may invaginate into the lamina propria and metaplastic changes in this epithelium can mimic invasive carcinoma. The lamina propria may be of variable thickness depending on the location within the bladder and it may or may not contain components of muscularis mucosae, which can be misinterpreted as muscularis propria. Since the layers of muscularis propria are usually irregular, establishing the presence of extravesical extension by tumor can be a challenge. Further complicating the issue, prior transurethral resections can induce changes in the cellular composition of the bladder wall, in essence masking normal anatomical landmarks. Since pathological stage is the most significant risk factor in predicting disease progression, understanding the microscopic anatomy of the viscus is of great importance.