The FISH test for the diagnosis, surveillance, and prognosis of transitional cell carcinoma of the bladder

A brief history of the fluorescence in situ hybridization [FISH] test and its use in the management of bladder tumors is outlined. After a brief review of the subject, between 1990 and the present, including sensitivity and specificity studies, a referenced list of the various uses of the FISH test is provided. It is concluded that the FISH test has almost completely replaced cystoscopy, urine cytology and all other tests and markers for the diagnosis, surveillance, management, and prognosis of bladder tumors. It has completely changed and revolutionized our previous routine of managing bladder tumors

Renal cell carcinoma ta with slow growth and prolonged survival

Three cases of renal cell carcinoma with prolonged survivals of 26, 23 and 15 years are reported.The three possible theories about prolonged survival are discussed in the light of a review of the literature

Renal fibrohistiocytic sarcoma. Three cases and a review of the literature

The purpose of this paper is to report three unpublished cases of so-cealed renal malignant fibrous histiocytoma which should be more appropriately called renal fibrohistiocytic sarcoma and to review and analyze the data concerning 41 cases collected from the literature and our three new cases making a total of 44 cases. Our third case is very interesting; in addition to the fact that this condition is rare, this particular patient also had concomitant nonmalignant ascites and compression of the descending colon, both conditions being rarely associated with renal cancer. The average age of the parients was 58 years; in 66'% of the cases the tumor involved the left kidney; 57% of the patients were males; the average tumor size was 12 cm; nephrectomy was performed in 93% of the cases; the average survival was 16 months. In none of the cases was a preoperative diagnosis correctly made. It is concluded that a triad of symptoms and signs [renal pain, weight loss, and large tumor size] as well as a triad of imaging characteristics [areas of low density on the CT scan, hypoechoic areas on ultrasound, and hypovascularity on angiography] may hold the promise of a preoperative diagnosis. It is suggested that the tumor arises from the system of Gerota's fascia-renal capsule

Spontaneous intraperitoneal rupture of the bladder

Spontaneous intraperitoneal rupture of the bladder [also called unsuspected, idiopathic, or non-traumatic rupture of the bladder] is a well defined but rare condition which has not been universally recognized in the past. We are reporting four cases and emphasizing its clinical picture so it might be better recognized and diagnosed early on in the process, and so that its management be planned appropriately in order to reduce its morbidity and its mortality. A review of the literature is provided to help achieve this end. Spontaneous intraperitoneal vesical rupture is almost always a surprise at laparotomy. A high degree of suspicion, the finding of urea in the ascitic fluid, and cystography may help in the diagnosis. Symptoms include abdominal pain, difficulty in micturition, hematuria and renal failure with elevation of the blood urea and acidosis. The etiology seems to be varied and somehow confused. We discuss four groups of etiological factors: dulled sensorium, weakening of the bladder wall, increased intra vesical pressure [with or without bladder outlet obstruction] and vascular lesions [radiotherapy, arterial embolism and vesical infarction]; and we try to discern common denominators for these four groups of etiological factors: an increase in intravesical pressure along with a weakening of the bladder wall. Finally the new concept of vesical infarction following ischemia due to overdistention of the bladder is introduced and discussed