Presented by Dr. Andres Matoso and prepared by Dr. Harsimar Kaur
Adult male with bladder mass.
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Adult male with bladder mass.
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Histology: The lesion is composed of broad based polypoid and papillary projections lined by urothelium that is thickened in areas and has acute and chronic inflammation. There is edema of the lamina propria.
Discussion: Polypoid, or papillary cystitis is a reactive lesion occurring most frequently in the bladder but it can occur anywhere in the urinary tract. When it presents in the urethra, it is called polypoid urethritis; in the renal pelvis, polypoid pyelitis, and in the ureter, polypoid ureteritis. Clinically, patients may present with hematuria and the cystoscopy can show a papillary/polypoid lesion, suspicious for papillary urothelial carcinoma. Patients often have a history of injury to the bladder including a previous urologic procedure, urinary stones, or indwelling catheter. Histologically, the lesion is composed of broad based papillary/polypoid projections of the mucosa with edema in the stalk and lamina propria and associated acute and chronic inflammation. The urothelium can be hyperplastic, but in contrast to low grade papillary urothelial carcinoma, there is no nuclear hyperchromasia or significant nuclear enlargement. In. contrast to PUNLMP, polypoid cystitis is inflamed, the papillary projections are broad based and do not show branching. Given the presence of inflammation, mitoses can be seen in association with reactive epithelial changes.
Histology: The lesion is composed of broad based polypoid and papillary projections lined by urothelium that is thickened in areas and has acute and chronic inflammation. There is edema of the lamina propria.
Discussion: Polypoid, or papillary cystitis is a reactive lesion occurring most frequently in the bladder but it can occur anywhere in the urinary tract. When it presents in the urethra, it is called polypoid urethritis; in the renal pelvis, polypoid pyelitis, and in the ureter, polypoid ureteritis. Clinically, patients may present with hematuria and the cystoscopy can show a papillary/polypoid lesion, suspicious for papillary urothelial carcinoma. Patients often have a history of injury to the bladder including a previous urologic procedure, urinary stones, or indwelling catheter. Histologically, the lesion is composed of broad based papillary/polypoid projections of the mucosa with edema in the stalk and lamina propria and associated acute and chronic inflammation. The urothelium can be hyperplastic, but in contrast to low grade papillary urothelial carcinoma, there is no nuclear hyperchromasia or significant nuclear enlargement. In. contrast to PUNLMP, polypoid cystitis is inflamed, the papillary projections are broad based and do not show branching. Given the presence of inflammation, mitoses can be seen in association with reactive epithelial changes.
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