Bladder - Arteriovenous malformation

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Bladder

Congenital anomalies

Arteriovenous malformation

Reviewers: Alcides Chaux, M.D., Instituto de Patología e Investigación (see Reviewers page)
Revised: 12 June 2011, last major update September 2010
Copyright: (c) 2003-2010, PathologyOutlines.com, Inc.

Definition
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● By definition, direct communication is present between arterioles and venules

Sites
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● More common in CNS, intestine, lung, extremities
● Very rare in urinary bladder

Etiology
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● Can be congenital or acquired (post-traumatic)

Clinical features
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● The most common symptom is hematuria (gross or micro, persistent or intermittent, may be massive)
● Other symptoms include dysuria, difficulty in voiding and urinary retention
● Some cases are asymptomatic

Case reports
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● Treated with transurethral resection (Int J Urol 2005;12:409)

Treatment
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● Excision is adequate therapy

Gross description
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● Large, broad-based, exophytic masses up to 6 cm (Am J Surg Pathol 2008;32:1213)
● Hemorrhagic, sometimes necrotic, surface

Micro description
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● Admixture of malformed vessels such as capillaries, arteries and venules
● Abrupt changes in thickness of medial and elastic layers of vessels, abnormal vascular dilation
● Often advanced small vessel disease, hemorrhage, ulceration (Hum Pathol 1986;17:94)
● Involves submucosa but not muscularis propria
● May be associated with pseudocarcinomatous epithelial hyperplasia of bladder (Am J Surg Pathol 2008;32:92)

Micro images
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Brain images: H&E and trichrome

Additional brain #1; #2

End of Bladder > Congenital anomalies > Arteriovenous malformation

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