Tumours I. Organic Diseases

ISBN-13: 9783642460876 / Angielski / Miękka / 2012 / 286 str.

Leslie N. Pyrah

Spis treści

Tumours of the Kidney and Ureter.- A. Introduction.- B. Aetiology.- I. General factor.- II. Carcinogenic substance.- III. Hormone inductio.- IV. Ionizing radiatio.- V. Malignant change in benign tumour.- C. Incidence.- I. Benign tumour.- II. Malignant tumour.- 1. Incidence of individual type.- 2. Ag.- 3. Se.- 4. Side affecte.- 5. Rac.- D. Classification.- I. Renal parenchym.- II. Renal pelvis and urete.- III. Renal capsul.- IV. Metastatic tumour.- V. Cyst.- E. Clinical features.- I. Symptom.- 1. The classical triad of symptom.- a) Haematuria.- b) Pain.- c) Tumour.- 2. Other symptom.- a) Pyrexia.- b) Loss of weight.- c) Varicocele.- d) Renal rupture.- e) Polycythaemia.- 3. Symptoms due to metastases.- 4. Silent cases.- II. Physical signs.- 1. Local.- 2. General.- 3. Urine.- 4. Blood.- F. Diagnosis.- I. History.- II. Physical examination.- III. Special diagnostic methods.- 1. Cystoscopy.- 2. Radiography.- a) Plain X-ray.- b) Excretion urography.- c) Instrumental urography.- d) Aortography.- e) Nephrotomography.- f ) Percutaneous kidney puncture.- g) Perirenal oxygen.- 3. Exfoliative cytology.- 4. Renal biopsy.- IV. Differential diagnosis.- 1. Palpable tumour.- 2. Haematuria.- 3. Pyelographic appearances.- 4. Metastases.- G. Consideration of individual tumours.- I. Renal parenchyma.- 1. Epithelial.- a) Benign.- b) Malignant.- 2. Connective tissue tumours.- a) Benign.- b) Malignant.- 3. Mixed tumours.- a) Benign.- b) Malignant.- II. Renal pelvis and ureter.- 1. Epithelial.- a) Benign and malignant.- 2. Connective tissue.- a) Benign.- b) Malignant.- III. Ureter.- 1. Epithelial.- 2. Connective tissue.- IV. Renal capsule.- V. Metastatic tumours.- VI. Cysts.- H. Treatment.- I. Surgical.- II. Radiotherapeutic.- III. Combined treatment.- IV. Hormone treatment.- V. Chemotherapy.- I. Prognosis.- I. Adenocarcinoma.- II. Pelvic and ureteric tumours.- III. Nephroblastoma.- References.- Tumours of Bladder.- A. Aetiology.- B. Symptomatology.- C. Diagnosis.- I. Cystoscopy.- II. Biopsy.- III. Urography.- IV. Cytology of urinary sediments.- D. Treatment.- I. Transurethral diathermy and resection.- II. Transvesical diathermy and resection.- III. Irradiation.- IV. Partial cystectomy.- V. Total cystectomy.- VI. External irradiation.- 1. General principles of external irradiation.- 2. Indications for external irradiation.- a) General pattern of tumour.- b) Histology.- c) Direct continuity spread.- d) Lymphatic spread.- e) Spread by blood stream.- 3. Method of treatment.- 4. Localisation of the growth.- 5. X-ray dosage.- 6. Results.- 7. Palliative treatment.- 8. Recurrence following other measures.- 9. Treatment of recurrences following radiotherapy.- 10. Follow up.- 11. Complications.- 12. Availability of apparatus.- E. Discussion on methods of treatment.- F. Secondary tumours of the bladder.- I. Carcinoma of the renal pelvis or ureter.- II. Metastases from distant sites.- III. Metastasis.- G. Non-epithelial tumours of the bladder.- H. Pathology (Contributed by T. SYMINGTON. J. M. SCOTT and K. M. GIRDWOOD).- I. Epithelial tumours.- 1. Malignant epithelial tumours.- a) Sex, age and site incidence.- b) Preparation of the specimen.- c) Morbid anatomy.- d) Microscopic appearance.- e) Changes in bladder mucosa adjacent to tumour.- f) Spread of tumours.- g) Cause of death in bladder tumours.- h) Classification of epithelial tumours of bladder.- j) Comment on classifications.- 2. Adenocarcinoma.- a) Primary adenocarcinoma.- b) Primary adenocarcinoma of urachal origin.- c) Secondary or metaplastic adenocarcinoma.- 3. Squamous epithelioma.- 4. Carcinoma complicating vesical diverticulum.- 5. Simple epithelial tumours.- Classification of biopsy material and application of histology grading.- II. Primary mesenchymal tumours of bladder.- 1. Benign mesenchymal tumours.- 2. Malignant mesenchymal tumours.- a) Fibrosarcoma (including fibromyxosarcoma).- b) Leiomyosarcoma.- c) Rhabdomyosarcoma.- d) Primary lymphosarcoma.- e) Primary osteogenic sarcoma and chondrosarcoma.- f) Angiosarcoma.- g) Miscellaneous group.- References.- Various Organic Diseases.- A. Infarction of the kidney.- I. Renal infarction from arterial occlusion.- 1. Pathology.- 2. Aetiological groups.- a) Cardiac disease.- b) Arterial disease.- c) Septic infarcts.- d) Infarction of the kidney following trauma.- 3. Clinical picture, diagnosis and treatment.- a) Usual clinical picture.- b) Renal injury and infarction.- c) Hypertension following renal infarction.- d) Anuria.- II. Thrombosis of the renal vein with haemorrhagic infarction.- 1. Pathology.- 2. Symptoms and diagnosis.- a) Infants.- b) Older children and adults.- 3. Treatment.- III. Thrombosis of the renal vein associated with thrombosis of the inferior vena cava.- B. Perirenal haematoma.- I. Aetiology.- 1. Traumatic haematoma.- 2. Spontaneous haematoma.- a) Diseases of the kidneys.- b) Diseases of the adrenal glands.- c) Diseases of the blood vessels.- d) Diseases of the blood or blood-forming organs.- e) Infections.- f) Diseases of the retroperitoneal organs and tissues.- g) Idiopathic, no cause being found.- II. Pathology.- III. Clinical picture and diagnosis.- 1. Acute cases.- 2. Subacute and chronic cases.- 3. Important causes of perirenal haematoma.- a) Renal tumours.- b) Hydronephrosis.- c) Renal infection.- d) Nephritis.- e) Arteriosclerosis and hypertension.- f) Periarteritis nodosa.- g) Adrenal causes.- h) Diseases of the blood or blood-forming organs.- i Acute pancreatitis.- j) Idiopathic causes.- IV. Treatment.- C. Movable kidney.- I. Degrees of mobility of the kidney.- II. Aetiology.- 1. Incidence.- 2. Causative factors.- a) Visceroptosis and posture.- b) Anatomical factors.- c) Injury.- d) Associated renal disease.- III. Pathological changes.- 1. The kidney and perinephric fat.- 2. Abnormal movements.- IV. Clinical picture.- 1. Symptoms.- a) Symptoms relating to the kidney.- b) Symptoms referred to other organs.- 2. Investigations.- V. Diagnosis.- 1. Other causes of pain.- 2. Swellings in the loin.- a) Mucocele of the gall bladder.- b) Riedel’s lobe of the liver.- c) Enlarged spleen.- d) Malignant colonic tumours.- VI. Treatment.- 1. Xon-operative treatment.- 2. Operative treatment.- Results of the operation of nephropexy.- D. Changes in size and posit ion of the bladder.- I. The normal bladder.- II. Alterations in the position of the bladder.- 1. Physiological.- 2. Pathological.- a) Fibroids of the uterine cervix.- b) A swelling in the pouch of Douglas.- c) Uterine prolapse.- d) Tumours of the pelvis.- e) Hernia of the bladder.- ?) Inguinal and femoral herniae.- ?) Incisional hernia.- III. Changes in the size of the bladder.- 1. Enlarged bladder.- a) Mega-ureter — megacystis syndrome.- b) Partial obstruction of the bladder neck and the urethra.- 2. Contracted bladder.- a) Contracted bladder following chronic cystitis.- b) Tuberculous contracted bladder.- c) Contracted bladder following interstitial cystitis.- E. Purpura of the bladder.- I. Symptomatic purpura affecting the urinary tract.- 1. Thrombocytopenic purpura.- 2. Anaphylactoid purpura.- II. Primary purpura of the urinary tract.- 1. Renal purpura.- 2. Purpura of the the bladder.- F. Foreign body in the bladder.- I. Classification.- 1. Along the urethra.- a) Self-introduced.- b) As a result of urological procedures.- 2. By way of penetrating wounds of the bladder.- 3. Following open surgical operations on the bladder.- 4. Migratory foreign bodies.- 5. By way of the intestine.- 6. From pelvic dermoids, tumours, or teratomata.- II. Symptoms.- III. Treatment.- G. Priapism.- I. Pathology.- II. Classification.- 1. Priapism due to neurogenic causes.- 2. Priapism due to local venous thrombosis.- 3. Priapism due to general disease and intoxications.- 4. Priapism due to primary or secondary malignant disease.- 5. Priapism due to diseases of the blood.- a) Leukaemia.- b) Sickle-cell anaemia.- c) Haemophilia.- 6. Priapism due to trauma.- 7. Idiopathic cases.- III. Age incidence.- IV. Clinical picture.- V. Treatment.- 1. Operative procedures.- a) Aspiration of the corpora cavernosa.- b) Incision.- c) Malignant priapism.- 2. Other measures.- H. Peyronie’s disease.- I. Aetiology.- II. Pathology.- III. Clinical picture and diagnosis.- IV. Treatment.- 1. Radiotherapy.- 2. Vitamin E.- 3. Cortisone.- 4. Surgical treatment.- J. Hydrocele.- I. Classification.- 1. By anatomy.- a) Primary hydrocele of the tunica vaginalis.- ?) Idiopathic hydrocele of the tunica vaginalis.- ?) Congenital hydrocele.- ?) Infantile hydrocele.- ?) Hydrocele associated with incomplete descent of the testis.- ?) Bilocular hydrocele.- b) Hydrocele of the testis.- c) Hydrocele of the spermatic cord.- ?) Encysted hydrocele of the cord.- ?) Diffuse hydrocele of the cord.- d) Hydrocele of a hernial sac.- e) Hydrocele of the canal of Nuck.- 2. By causation.- a) Primary.- ?) Acute.- ?) Chronic.- b) Secondary.- ?) Acute.- ?) Chronic.- 3. By contents.- a) Chylous hydrocele.- b) Meconium hydrocele.- c) Pyocele.- II. Age incidence.- III. Pathology.- 1. Causation.- 2. Pathological anatomy.- IV. Primary hydrocele of the tunica vaginalis.- 1. Clinical picture.- a) Symptoms and signs.- b) Complications.- 2. Diagnosis.- 3. Treatment.- a) Tapping.- b) Injection of sclerosing fluids.- ?) The solution.- ?) Contra-indications.- ?) Technique.- ?) Results of injection.- c) Operative treatment.- ?) Excision of the parietal layer of the tunica vaginalis.- ?) Inversion of the hydrocele sac.- ?) Complications of operation.- V. Congenital hydrocele.- VI. Infantile hydrocele.- VII. Bilocular hydrocele.- VIII. Hydrocele of the spermatic cord.- 1. Encysted hydrocele of the cord.- 2. Diffuse hydrocele of the cord.- IX. Hydrocele of an inguinal hernial sac.- X. Hydrocele of the canal of Xuck.- XI. Secondary hydrocele.- XII. Chylous hydrocele.- XIII. Meconium hydrocele.- XIV. Pyocele.- K. Haematocele.- I. Haematocele of the tunica vaginalis.- 1. Aetiology.- 2. Pathology.- 3. Clinical picture.- a) Haematocele resulting from gross trauma.- b) Symptomatic haematocele.- c) Chronic haematocele.- 4. Diagnosis.- 5. Treatment.- II. Haematocele of the spermatic cord.- 1. Encysted haematocele of the spermatic cord.- 2. Diffuse haematocele of the spermatic cord.- L. Varicocele.- I. Primary, spontaneous or idiopathic varicocele.- 1. Pathology.- 2. Clinical features and diagnosis.- 3. Treatment.- a) Treatment by injection.- b) Operative treatment.- ?) The low operation.- ?) The high operation.- II. Symptomatic or secondary varicocele.- III. Varicocele and subfertility.- M. Cysts of the epididymis.- I. Surgical anatomy.- II. Pathology.- 1. Pathogenesis.- a) Cysts originating in embryonic remains.- b) Retention cysts of the epididymis.- c) Polycystic disease of the epididymis.- 2. Causative factors.- 3. Pathological anatomy.- III. Aetiology.- IV. Symptoms.- V. Differential diagnosis.- 1. Hydrocele.- 2. Encysted hydrocele of the cord.- 3. Haematocele.- 4. Hernia.- 5. Varicocele.- 6. Nodules in the epididymis.- 7. Torsion of the testis, gummata and solid tumours of the testis.- VI. Treatment.- 1. Non-operative.- 2. Operative.- N. Torsion of the testicle and of the appendages of the testis and the epididymis.- I. Torsion of the testicle.- 1. Aetiology.- 2. Pathology.- a) Pathological anatomy.- ?) Extra-vaginal torsion.- ?) Intra-vaginal torsion.- ?) Torsion between the testis and the epididymis.- b) Pathological changes.- c) Rarer variants of torsion.- 3. Clinical picture and diagnosis.- 4. Treatment.- II. Torsion of the appendages of the testis and the epididymis.- 1. Anatomy of the appendages.- 2. Torsion of the appendix testis.- a) Aetiology.- b) Clinical picture and diagnosis.- c) Treatment.- 3. Torsion of the other appendages.- References.- Author Index.