Transitional cell tumors of the renal pelvis and ureter associated with capillarosclerosis indicating analgesic abuse

Abstract

An association between transitional cell tumors (TCT) and abuse of compound analgesics has been established during the past two decades. Recently thickening of basement membranes around subepithelial capillaries, known as capillarosclerosis, has been reported as a change in the urinary tract pathognomonic for a long-standing abuse of compound analgesics. Therefore the authors reviewed pathologic and clinical data in 59 patients treated for TCT of the renal pelvis or ureter. Capillarosclerosis was found in nine cases (15%) of the TCT group but not in any of the cases selected as controls. Capillarosclerosis is suggested as a valuable marker, which always should be looked for in bladder biopsy specimens. Whenever present it should arouse suspicion of analgesic abuse, and the associated increased risk for developing TCT of the renal pelvis or ureter should be borne in mind.

Overexpression of cyclooxygenase‐2 in high‐grade human transitional cell carcinoma of the upper urinary tract

“…TCC of the upper urinary tract appears to share a similar aetiology with that of the urinary bladder. However, the aetiology is not identical, as some substances such as phenacetin [14], Chinese herbs [15] and thorium‐containing radiological contrast material [16] induce TCC more predominantly in the upper urinary tract than in the urinary bladder. In the present study we examined COX‐2 expression in human TCC of the upper urinary tract, showing for the first time that COX‐2 is frequently overexpressed in upper urinary tract TCC, associated with degree of tumour cell differentiation, indicating that COX‐2 can be a target for chemoprevention of this carcinoma.…”

Prognostic factors for upper urinary tract urothelial carcinomas: stage, grade, and smoking status

“…Its etiology is similar to that of the urinary bladder cancer: it is frequently affected by environmental factors (chronic infection, urolithiasis, cigarette smoking, and the use of aniline stains, phenacetine, cyclophosphamide, and iphosphamide) [2,3]. More than 50% of patients with UUT-TCC are diagnosed at the T2 and advanced stages of the disease, and the 5-year survival rate of these patients varies from 30 to 60% [4][5][6].…”

Higher risk of urothelial carcinoma in the upper urinary tract than in the urinary bladder in hemodialysis patients

“…25 Some studies have reported that an increased risk of UC in patients with ESRD is associated with the usage of Chinese herbal products and analgesics, especially in the upper urinary tract. 26 A preliminary study investigating the effect of arsenic in renal parenchymal tissue of patients with UC and ESRD did not find any increase in the metal compared to patients without UC.…”