Pulmonary manifestations of urothelial carcinoma of the bladder

Abstract

Urothelial carcinoma (Transitional cell carcinoma) of the bladder is the pre-dominant histological type of bladder cancer in the United States and Europe. Patients with bladder cancer usually present with painless hematuria. The diagnosis is often delayed, as the symptoms are similar to various other benign conditions such as urinary tract infection, prostatitis or renal calculi. In some patients, the metastatic lesions will cause the initial presenting symptoms. We conducted a MedLine/PubMED search identifying all relevant articles with "pulmonary manifestations", "urothelial bladder cancer", "manifestations of bladder cancer" or a combination of these terms in the title. The pulmonary manifestations of urothelial carcinoma of the bladder include metastatic disease including cavitary lesions, endobronchial, pleural, or lymph node metastasis pleural effusion and chylothorax. Pulmonary embolism and tumor embolism is another manifestation of this cancer. Intravesical Bacillus Calmette-Gurin therapy for bladder cancer has been associated with a range of adverse effects including the systemic spread of Bacilli Calmette-Guérin immunotherapy affecting the lungs. Other drugs used to treat bladder cancer can be associated with drug-related pneumonitis. Other rare manifestations include a sarcoid like reaction and systemic granulomatous disease to Bacilli Calmette-Guérin therapy. In this review we discuss the various pulmonary manifestations of urothelial carcinoma of the bladder. A high index of suspicion with these presentations can lead to an early diagnosis and assist in instituting an appropriate intervention.

Impact of Gene Polymorphisms in GAS5 on Urothelial Cell Carcinoma Development and Clinical Characteristics

“…Urothelial cell carcinoma (UCC), also called transitional cell carcinoma, typically involves the urinary system and can develop in the lining of epithelial cells of the urethra, ureters, renal pelvis, or bladder [1]. UCC is the predominant histologic type in the United States, accounting for more than 90% of all bladder cancers; approximately 25% of patients with bladder cancer have muscle-invasive disease [2]. UCC of the bladder represents the fifth most commonly diagnosed malignancy in the United States [3], and patients with bladder cancer usually present with painless hematuria.…”

Bacillus Calmette-Guérin pneumonitis after intravesical instillation: Report of two cases and a review of the literature

“…In the diagnostic evaluation, effort should be made to confirm the diagnosis by demonstrating the presence of BCG. Metastatic spread or complications of malignancy like pulmonary embolism should also be considered in the differential diagnosis 46 . In fact, one patient in the present series had both lung metastases and BCG granulomatous pneumonitis.…”

Pulmonary lymphangitis carcinomatosa in a patient with carcinoma of urinary bladder

“…The pulmonary metastasis due to bladder cancer is usually solid, discreet nodular but can rarely be cavitary or endobronchial. [ 7 ] The association of bladder cancer and lymphangitis carcinomatosa is rare, and to the best of our knowledge, only two such cases have been reported in the English literature. [ 2 3 ] The nested variant of the TCC is an uncommon but aggressive tumor with a tendency to cause early metastasis.…”