103.A 65-year-old African-American man who has a history of both uri-
nary tract infections and urinary stones presents at the urology clinic with
hematuria. He has a dietary history high in saturated fats and has been
exposed to second-hand smoke both at home (his wife smokes) and at
work where many of his coworkers smoke. His work as a machinist
exposed him to metal parts. Before working as a machinist he worked as a
commercial painter. Cystoscopy identified several bladder tumors and was
followed by transuretheral resection and biopsy (TURB). The biopsy shows
a transitional cell carcinoma 4.5 cm. in diameter staged as “T3aN1M2.”
Which of the following would facilitate the processes involved in the “M2”
classification?
a. Lysyl oxidase
b. Metalloproteinases
c. Plasminogen
d. Serpins
e. TIMPs
180 Anatomy, Histology, and Cell Biology