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Bladder
Bladder tumors - benign
Condyloma acuminatum
Author: Nat Pernick, M.D. (see Authors page)
Revised: 8 December 2009, last major update - December 2009 – UPDATE IN PROGRESS
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Definition
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● HPV related lesion; similar to lesions elsewhere
Terminology
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● Call squamous papilloma if no koilocytosis and HPV negative
Epidemiology
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● Rare to only involve the bladder
Etiology
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● Caused by HPV, almost always subtypes 6 and 11 and not 16 or 18
Clinical features
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● Usually occurs by direct extension from genital lesions
● Associated with long-standing cystotomy, indwelling catheters, fistulas, immunosuppression
● Usually not associated with squamous cell carcinoma of bladder (Am J Surg Pathol 2007;31:1777, Am J Surg Pathol 2006;30:883)
Case reports
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● Due to HPV 16/18 (Int J STD AIDS 2004;15:836)
● Progressing to poorly differentiated spindle cell carcinoma (Scand J Urol Nephrol 2003;37:512)
● 62 year old man with subsequent warty carcinoma (Int J Surg Pathol 2000;8:253)
Treatment
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● May recur, but doesn’t progress to carcinoma
Gross description (Macroscopy)
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● Smooth, pink-tan, papillary
Gross images
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Images: extensive bladder involvement
Micro description (Histopathology)
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● Resembles condylomas at other sites: papillary fronds lined by hyperplastic and metaplastic squamous epithelium with koilocytosis (perinuclear halos), wrinkled nuclei and binucleated cells
● Variable atypia but no anaplasia
Micro images
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Images: #1; #2; #3; Fig A: subtle koilocytotic change; Fig B: HPV in situ hybridization is positive in deeper section
Cytology description
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●
Cytology images
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Positive stains
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● HPV 6, 11
● p53
Negative stains
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●
Electron microscopy descriptions
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●
Electron microscopy images
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Molecular / cytogenetics description
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● Aneuploid
Molecular / cytogenetics images
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Differential Diagnosis
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● Squamous papilloma: no koilocytes, HPV negative, p53 negative, diploid (Cancer 2000;88:1679)
● Verrucous carcinoma: invasive margins, anaplasia, HPV negative
Additional references
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End of Bladder > Bladder tumors-benign > Condyloma acuminatum
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