Transitional epithelium

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Transitional epithelium

Transitional epithelium

Transitional epithelium of the urinary bladder, known as urothelium.

The rounded surface of the apical cells is a distinguishing characteristic

of this type of epithelium.

Details

System Urinary system

Identifiers

TH H2.00.02.0.02033

Anatomical terms of microanatomy

[edit on Wikidata]
 This article is part of a series on

Epithelia

Squamous epithelial cell

 Simple
 Stratified

Columnar epithelial cell

 Simple
 Stratified
 Pseudostratified

Cuboidal epithelial cell

 Simple
 Stratified

Specialised epithelia
 Olfactory
 Respiratory
 Intestinal
 Transitional
 Vaginal
 Germinal 
o female
o male

Other
 Table of epithelia of human organs

 v
 t
 e
 Transitional epithelium animation, highlighting the epithelial layer, then underlying connective tissue.
Contrast the messy appearance of the epithelial surface to other epithelial tissues.

Transitional epithelium is a type of stratified epithelium. This tissue consists of

multiple layers of epithelial cells which can contract and expand in order to adapt
to the degree of distension needed. Transitional epithelium lines the organs of
the urinary system and is known here as urothelium. The bladder for example
has a need for great distension.

Contents

 1Structure
o 1.1Cell layers
o 1.2Cell membrane
 2Function
 3Clinical significance
o 3.1Carcinoma
o 3.2Urothelial lesions
 4Gallery
 5References
o 5.1Bibliography
 6External links

Structure[edit]
The appearance of transitional epithelium differs according to its cell layer. Cells
of the basal layer are cuboidal (cube-shaped), or columnar (column-shaped),
while the cells of the superficial layer vary in appearance depending on the
degree of distension.[1] These cells appear to be cuboidal with a domed apex
when the organ or the tube in which they reside is not stretched. When the organ
or tube is stretched (such as when the bladder is filled with urine), the tissue
compresses and the cells become stretched. When this happens, the cells
flatten, and they appear to be squamous and irregular.
Cell layers[edit]
Transitional epithelium is made up of three types of cell layers: basal,
intermediate, and superficial.[2] The basal layer fosters the epithelial stem cells in
order to provide constant renewal of the epithelium. [3] These cells' cytoplasm is
rich in tonofilaments and mitochondria; however, they contain few rough
endoplasmic reticulum. The tonofilaments play a role in the attachment of the
basal layer to the basement membrane via desmosomes.[4] The intermediate cell
layer is highly proliferative and, therefore, provides for rapid cell regeneration in
response to injury or infection of the organ or tube in which it resides. [3] These
cells contain a prominent Golgi apparatus and an array of membrane-bound
vesicles.[4] These function in the packaging and transport of proteins, such as
keratin, to the superficial cell layer. The cells of the superficial cell layer that lines
the lumen are known as facet cells or umbrella cells. This layer is the only fully
differentiated layer of the epithelium. It provides an impenetrable barrier between
the lumen and the bloodstream, so as not to allow the bloodstream to reabsorb
harmful wastes or pathogens.[3] All transitional epithelial cells are covered
in microvilli and a fibrillar mucous coat.[2]
The epithelium contains many intimate and delicate connections to neural and
connective tissue. These connections allow for communication to tell the cells to
expand or contract. The superficial layer of transitional epithelium is connected to
the basal layer via cellular projections, such as intermediate filaments protruding
from the cellular membrane. These structural elements cause the epithelium to
allow distension; however, these also cause the tissue to be relatively fragile and,
therefore, difficult to study. All cells touch the basement membrane. [citation needed]
Cell membrane[edit]
Because of its importance in acting as an osmotic barrier between the contents
of the urinary tract and the surrounding organs and tissues, transitional
epithelium is relatively impermeable to water and salts. This impermeability is
due to a highly keratinized cellular membrane synthesized in the Golgi
apparatus.[5] The membrane is made up of a hexagonal lattice put together in the
Golgi apparatus and implanted into the surface of the cell by reverse pinocytosis,
a type of exocytosis.[6] The cells in the superficial layer of the transitional
epithelium are highly differentiated, allowing for maintenance of this barrier
membrane.[6] The basal layer of the epithelium is much less differentiated;
however, it does act as a replacement source for more superficial layer. [6] While
the Golgi complex is much less prominent in the cells of the basal layer, these
cells are rich in cytoplasmic proteins that bundle together to form tonofibrils.
These tonofibrils converge at hemidesmosomes to attach the cells at the
basement membrane.[4]

Function[edit]
The transitional epithelium cells stretch readily in order to accommodate
fluctuation of volume of the liquid in an organ (the distal part of the urethra
becomes non-keratinized stratified squamous epithelium in females; the part that
lines the bottom of the tissue is called the basement membrane). Transitional
epithelium also functions as a barrier between the lumen, or inside hollow space
of the tract that it lines and the bloodstream. To help achieve this, the cells of
transitional epithelium are connected by tight junctions, or virtually impenetrable
junctions that seal together to the cellular membranes of neighboring cells. This
barrier prevents re-absorption of toxic wastes and pathogens by the bloodstream.

Clinical significance[edit]
Urothelium is susceptible to carcinoma. Because the bladder is in contact with
urine for extended periods, chemicals that become concentrated in the urine can
cause bladder cancer. For example, cigarette smoking leads to the concentration
of carcinogens in the urine and is a leading cause of bladder cancer. Aristolochic
acid, a compound found in plants of the family Aristolochiaceae, also
causes DNA mutations and is a cause of liver, urothelial and bladder cancers.
[7]
 Occupational exposure to certain chemicals is also a risk factor for bladder
cancer. This can include aromatic amines (aniline dye), polycyclic aromatic
hydrocarbons, and diesel engine exhaust.[8]
Carcinoma[edit]
Main article: Carcinoma
Carcinoma is a type of cancer that occurs in epithelial cells. Transitional cell
carcinoma is the leading type of bladder cancer, occurring in 9 out of 10 cases.
[9]
 It is also the leading cause of cancer of the ureter, urethra, and urachus, and
the second leading cause of cancer of the kidney. Transitional cell carcinoma can
develop in two different ways. Should the transitional cell carcinoma grow toward
the inner surface of the bladder via finger-like projections, it is known as papillary
carcinoma. Otherwise, it is known as flat carcinoma. [9] Either form can transition
from non-invasive to invasive by spreading into the muscle layers of the bladder.
Transitional cell carcinoma is commonly multifocal, more than one tumor
occurring at the time of diagnosis.
Transitional cell carcinoma can metastasize, or spread to other parts of the body
via the surrounding tissues, the lymph system, and the bloodstream. It can
spread to the tissues and fat surrounding the kidney, the fat surrounding the
ureter, or, more progressively, lymph nodes and other organs, including bone.
Common risk factors of transitional cell carcinoma include long-term misuse of
pain medication, smoking, and exposure to chemicals used in the making of
leather, plastic, textiles, and rubber.[10]
Transitional cell carcinoma patients have a variety of treatment options. These
include nephroureterectomy, or the removal of kidney, ureter, and bladder cuff,
and segmental resection of the ureter. This is an option only when the cancer is
superficial and infects only the bottom third of the ureter. The procedure entails
removing the segment of cancerous ureter and reattaching the end. [10] Patients
with advanced bladder cancer or disease, also often look to bladder
reconstruction as a treatment. Current methods of bladder reconstruction include
the use of gastrointestinal tissue. However, while this method is effective in
improving the function of the bladder, it can actually increases the risk of cancer,
and can cause other complications, such as infections, urinary stones, and
electrolyte imbalance. Therefore, other methods loom in the future. For example,
current research paves the way for use of pluripotent stem cells to derive
urothelium, as they are highly and indefinitely proliferative in vitro (i.e. outside of
the body).[3]
Urothelial lesions[edit]
 Papillary urothelial lesions
o Papillary urothelial hyperplasia
o Urothelial papilloma
o Papillary urothelial neoplasm of low malignant potential (PUNLMP)
o Low-grade papillary urothelial carcinoma
o High-grade papillary urothelial carcinoma
o Invasive urothelial carcinoma
 Flat urothelial lesions
o Reactive urothelial atypia
o Urothelial inverted papilloma
o Urothelial atypia of unknown significance
o Urothelial dysplasia
o Urothelial carcinoma in situ
 Invasive urothelial carcinoma
o Invasive urothelial carcinoma (NOS)
o Urothelial carcinoma with inverted growth pattern
o Urothelial carcinoma with squamous differentiation
o Urothelial carcinoma with villoglandular differentiation
o Urothelial carcinoma, micropapillary variant
o Urothelial carcinoma, lymphoepithelioma-like variant
o Urothelial carcinoma, clear cell (glycogen-rich) variant
o Urothelial carcinoma, lipoid cell variant
o Urothelial carcinoma with syncitiotrophoblastic giant cells
o Urothelial carcinoma with rhabdoid differentiation
o Urothelial carcinoma similar to giant cell tumor of bone

Gallery[edit]


Types of epithelium
 
 

Schematic view of transitional epithelium

 

Vertical section of bladder wall.

 

Transverse section of ureter.

References[edit]
1. ^ Marieb, E., & Hoehn, K. (2013). Human anatomy & physiology (9th ed., pp. 122-
124). Boston: Pearson.
2. ^ Jump up to:a b Monis, B., & Zambrano, D. (1968). Ultrastructure of transitional
epithelium of man. Zeitschrift für Zellforschung und Microscopical Anatomie, 87(1), 101-117.
3. ^ Jump up to:a b c d Osborn, S. L., & Kurzrock, E. A. (2015). Production of Urothelium
from Pluripotent Stem Cells for Regenerative Applications. Current Urology Reports, 16(1),
1+. Retrieved from http://go.galegroup.com/ps/i.do?id=GALE
%7CA390522720&v=2.1&u=clemsonu_main&it=r&p=AONE&sw=w&asid=bf6961c15c9b9523
113dee93fd8df89c