Transitional Cell Layer Research Articles

Study on White Patch in the Female Bladder Neck

The presence of white patch in the female urinary bladder neck is well-known in the literature, but the nature is not clear. I have recognized white patch in the distal part of the female trigone, near the bladder neck on careful cystoscopic observations. These patches are different appearance from the typical white or gray patches to clouds of epithelium. I examine these patches and some new histologic findings were found. Some experimental study using estrogen or progesterone administration to these patients were performed. In addition the patches alter in the menstral cycles. The details were as followd : 1) The bladder neck of 833 cases were studied by cystoscopic examination and white patsches were found in 276 cases (33.1%). 2) Biopsies of the patsches of 66 cases from 17 to 70 years of age in 276 cases, were performed. The histological natures of these patches were completely different from the transitional cell layers of the urinary bladder. Three types of the patches were noticed histologically. Type I. The basal layers are composed of cylindrical cells, and above these, there are many celles of spinous layers, in which the intercellular bridges are seen. Above these layers the polygonal celles with large nuclei arefound. The superficial celles are flatt and contained nuclei. These layers are parakeratosis but there are not the zone of keratosis. Type II. This type is almost same as type I without the uncertaing the spinous layer in a few cases and the large perinucleare clear cytoplasma with picnotic nuclei were found. In these cells the considerable amounts of glycogen are demonstrated. Several cases have no parakeratosis. Type III. The bassl zone of epithelium consists of ratherthe transitional type cells than the cylindrical, and there are no spinous layers. The superficial cells have polygonal cleare cytoplasma with picnotic nuclei. There are no parakeratosis. This type is interpreted as a hydropic transformation of epithelium by Stoerk. 3) The administrations of estrogen and progesterone change the size, shape and type of the patches. The estrogen are administratied to 11 case. Cystohoricelly estrogen makes the patch bigger and thicker. Histologically estrogen makes more parakeratoric layer and thiner polygonal clear celles with picnotic nuclei and in few cases it alters from type III to II. The progesterone administraction are performed to 9 cases which makes the patch smaller and thinner. Histologically makes the layer less parakeratotic and move polygonal clear celles with picnotic nuclei, and it renders to alter from type II to type III. 4) The periodical changes of the white patches in the menstrual cycles of 9 cases and post-menstrnal changes of 11 cases were studied with following findings. The histological findings are altered in the menstrual cycles and sometimes even the types are also altered in these cycles. The postmenstrual change of the patches are a certain type which are lack of sex hormone and are type I. 5) The inflammation of the urinary bladder neck makes the patch bigger, the patch may be the metaplasia stimulatied of inflammation and estrogen, in the bladder neck mucosa originated from the epithelium of urogenital sinus. 6) These white patches are strictly differentiated from leukoplakia, because these patches in the bladder neck have embryonal predisposition and may be hormone-sensitive squamous metaplasia.