Pathologie tumorale de la vessie - 26/01/10

[34-403-A-10] - Doi : 10.1016/S1241-8218(10)52096-1

C. Roy ^⁎ : Professeur des Universités, praticien hospitalier de radiologie, A. Matau : Chef de clinique-assistant des Hôpitaux
Service de radiologie B, Hôpitaux universitaires de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France

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Articolo archiviato , inizialmente pubblicato nel trattato EMC : RADIOLOGIE ET IMAGERIE MÉDICALE : Génito-urinaire - Gynéco-obstétricale - Mammaire

Résumé

Le cancer de la vessie est fréquent et grave. Il s'agit le plus souvent d'une tumeur épithéliale de type excréto-urinaire. Bien que l'échographie reste essentielle, le diagnostic appartient à la cystoscopie avec des prélèvements histologiques. La tomodensitométrie (TDM) intervient dans le bilan locorégional et explore le haut appareil urinaire avec la technique de l'uroscanner. L'imagerie par résonance magnétique (IRM) est plus performante pour le bilan des grosses tumeurs. En routine clinique, les performances de la TDM et de l'IRM sont voisines pour le bilan ganglionnaire. Les perspectives de l'IRM (produits de contraste à base de microparticules de fer pour une lympho-IRM et l'imagerie de diffusion) sont en évaluation.

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Mots clés : Vessie, Tumeur maligne, Échographie, Tomodensitométrie, Uroscanner, Imagerie par résonance magnétique

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Introduction

Classification des tumeurs de la vessie^{[Oosterlinck W., Solsona E., van der Meijden A.P.M., Sylvester R., Boehle A., Rintala E., e al. European Association of Urology. EAU guidelines on diagnosis and treatment of upper urinary tract transitional cell carcinoma Eur. Urol. 2004 ; 46 : 147-154

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]}

Tumeurs épithéliales de la vessie

Épidémiologie

Anatomie pathologique^{[Mostofi F.K., Davis C.J., Sesterhenn I.A. Histological typing of urinary bladder tumours World Health Organization international histologic classification of tumours Heidelberg: Springer-Verlag (1999).

, Bittard M., Bittard H., Billerey C.I., Schraub S., Lamy B., Flam T. Cancer de la vessie Cancers urogénitaux Paris: Flammarion Médecine-Sciences (1991).
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, Zhang J., Gerst S., Lefkowitz R.A., Bach A. Imaging of bladder cancer Radiol. Clin. North Am. 2007 ; 45 : 183-205

, Yousem D.M., Gatewood O.M., Goldman S.M., Marshall F.F. Synchronous and metachronous transitional cell carcinoma of the urinary tract: prevalence, incidence, and radiographic detection Radiology 1988 ; 167 : 613-618

, Witjes J.A. Bladder carcinoma in situ in 2003: State of the art Eur. Urol. 2004 ; 45 : 142-146

]}

Pronostic et évolution

Diagnostic de tumeur vésicale

Clinique

Échographie de l'appareil urinaire^{[Datta S.N., Allen G.M., Evans R., Vaughton K.C., Lucas M.G. Urinary tract ultrasonography in the evaluation of haematuria: a report of over 1,000 cases Ann Coll Surg Engl 2002 ; 84 : 203-205

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]} (, , , , , )

Examen endoscopique

Bilan d'extension locorégionale

Tomodensitométrie^{[Schreyer H.H., Uggowtzer M.M., Rupper-Kohlmayr A. Helical CT of the urinary organs Eur. Radiol. 2002 ; 12 : 575-591

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Imagerie par résonance magnétique^{[Barentsz J.O., Jager G.J., Witjes J.A. MR imaging of the urinary bladder Magn. Reson. Imaging Clin. N. Am. 2000 ; 8 : 853-867

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, Narumi Y., Kadota T., Inoue E., Kuriyama K., Horinouchi T., Kasai K., e al. Bladder wall morphology: in vitro MR imaging-histopathologic correlation Radiology 1993 ; 187 : 151-155

, Barentsz J.O., Engelbrecht M., Jager G.J., Witjes J.A., de LaRosette J., van Der Sanden B.P., e al. Fast dynamic gadolinium-enhanced MR imaging of urinary bladder and prostate cancer J. Magn. Reson. Imaging 1999 ; 10 : 295-304 3.0.CO;2-Z">[cross-ref]}

, , , ] (, , , , )

Comparaison TDM-IRM^{[Tanimoto A., Yuasa Y., Imai Y., Izutsu M., Hiramatsu K., Tachibana M., e al. Bladder tumor staging: comparison of conventional and gadolinium enhanced dynamic MR imaging and CT Radiology 1992 ; 185 : 741-747

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, Barentsz J.O., Jager G.J., Witjes J.A., Ruijs J.H. Primary staging of urinary bladder carcinoma: the role of MRI and a comparison with CT Eur. Radiol. 1996 ; 6 : 129-133

]}

Extension ganglionnaire^{[Jager G.J., Barentsz J.O., Oosterhof G.O. Pelvic lymphadenopathy in prostatic and urinary bladder carcinoma: MR imaging with a three-dimensional T1-weighted magnetization-prepared-rapid gradient-echo sequence AJR Am. J. Roentgenol. 1996 ; 167 : 1503-1507

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Formes cliniques^{[Wong-You-Cheong J.J., Woodward P.J., Manning M.A., Sesterhenn I.A. From the archives of the AFIP neoplasms of the urinary bladder: radiologic-pathologic correlation Radiographics 2006 ; 26 : 553-580

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, Lee S.H., Kitchens H.H., Kim B.S. Adenocarcinoma of the urachus: CT features J. Comput. Assist. Tomogr. 1990 ; 14 : 232-235

]}

Tumeur développée dans un diverticule vésical ()

Tumeur de l'ouraque^{[Bricks S., Friedman A., Pollack H. Urachal carcinoma: CT findings Radiology 1988 ; 169 : 377-381

, Lee S.H., Kitchens H.H., Kim B.S. Adenocarcinoma of the urachus: CT features J. Comput. Assist. Tomogr. 1990 ; 14 : 232-235

]} ()

Tumeurs non épithéliales de la vessie^{[Kabalin C. Leiomyoma of the bladder Urology 1990 ; 35 : 210-212

, Maya M.M., Slywotzky C. Urinary bladder leiomyoma: magnetic resonance imaging findings Urol. Radiol. 1992 ; 14 : 197-199

, Fletcher B.D., Kaste S.C. Magnetic resonance imaging for diagnosis and follow-up of genitourinary, pelvic, and perineal rhabdomyosarcoma Urol. Radiol. 1992 ; 14 : 263-272

, Chen M., Lipson S.A., Hricak H. MR imaging evaluation of benign mesenchymal tumors of the urinary bladder AJR Am. J. Roentgenol. 1997 ; 168 : 399-403

, Juraascheck F., Egloff H., Buemi A., Laedleingreilsammer D. Paraganglioma of urinary bladder Urology 1983 ; 22 : 659-662

, Shonnard K.M., Jelinek J.S., Benedikt R.A., Kransdorf M.J. CT and MR of neurofibromatosis of the bladder J Comput Assist Tomogr 1992 ; 16 : 433-438

, Gupta A.K., Bhargava S. Bladder hemangioma: ultrasonographic demonstration Urol. Radiol. 1987 ; 9 : 181-182

, Fujiwara T., Sugimura K., Imaoka I., Igawa M. Inflammatory pseudotumor of the bladder: MR findings J. Comput. Assist. Tomogr. 1999 ; 23 : 558-561

, Warshawsky R., Bow S.N., Waldbaum R.S., Cintron J. Bladder pheochromocytoma with MR correlation J. Comput. Assist. Tomogr. 1989 ; 13 : 714-716

, Shook T.E., Nybergy L.M. Endometriosis of the urinary tract Urology 1988 ; 31 : 1-6

]}

Tumeurs musculaires^{[Kabalin C. Leiomyoma of the bladder Urology 1990 ; 35 : 210-212

, Maya M.M., Slywotzky C. Urinary bladder leiomyoma: magnetic resonance imaging findings Urol. Radiol. 1992 ; 14 : 197-199

]}

Autres tumeurs conjonctives primitives^{[Chen M., Lipson S.A., Hricak H. MR imaging evaluation of benign mesenchymal tumors of the urinary bladder AJR Am. J. Roentgenol. 1997 ; 168 : 399-403

, Juraascheck F., Egloff H., Buemi A., Laedleingreilsammer D. Paraganglioma of urinary bladder Urology 1983 ; 22 : 659-662

, Shonnard K.M., Jelinek J.S., Benedikt R.A., Kransdorf M.J. CT and MR of neurofibromatosis of the bladder J Comput Assist Tomogr 1992 ; 16 : 433-438

]}

Autres tumeurs primitives

Tumeurs secondaires

Conflit d'intérêt

Esportazione

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Cliché sans préparation de l'appareil urinaire
O. Hélénon, C. Delavaud, J. Dbjay, A. Khairoune, J.-M. Correas

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