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Bladder
Acquired non-neoplastic anomalies
Author: Nat Pernick, M.D. (see Authors page)
Editor: name, affiliation
Revised: 9 February 2010, last major update - February 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Pouchlike evaginations of bladder wall
Terminology
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Epidemiology
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● For cases with pathologic sampling, mean age is 55 years, >90% male (Arch Pathol Lab Med 2009;133:791)
Sites
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Etiology
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● If congenital, due to bladder outlet obstruction or failure of muscle development
● Acquired cases are more common and usually due to prostatic enlargement causing muscular hypertrophy and focal mucosal herniation without muscularis propria in areas of weakness, often near ureteral orifices, bladder dome or urethral orifice
Clinical features
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● Often multiple in posterior wall or trigone
● Associated with infections and stones (due to urine stasis), perforation, carcinoma (urothelial / other)
● Tumors are often large because location is hidden
● Increased frequency of less common carcinoma subtypes
Prognostic factors
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Case reports
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● 57 year old man with distended diverticulum causing colonic obstruction (World J Gastroenterol 2009;15:3957)
● 62 year old man with diverticulum due to chronic catheterization (Cases J 2009 Jan 9;2(1):36)
● 65 year old man with sarcomatoid carcinoma / carcinosarcoma (Arch Pathol Lab Med 2002;126:853)
● 90 year old woman with gastric metastasis to diverticulum (World J Surg Oncol 2005 Aug 24;3:55)
Treatment
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● Varies by patient - nonoperative treatment, surgical bladder outlet reduction or removal of the diverticulum
Clinical images
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Gross description (Macroscopy)
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● Narrow necks, round/ovoid pouch from 1-10 cm
Gross images
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Drawing
Image with case history
Diverticulum containing sarcomatoid carcinoma
Micro description (Histopathology)
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● Wall consists of fibrous tissue with no/scant muscularis propria
● Squamous or glandular metaplasia present if inflamed
Micro images
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Histologic features
Subtypes of invasive bladder cancer arising in bladder diverticula
Diverticulum containing sarcomatoid carcinoma
Cytology description
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Cytology images
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Positive stains
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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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Molecular / cytogenetics images
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Differential Diagnosis
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● (link to topic)
Additional references
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End of Bladder > Acquired non-neoplastic anomalies > Diverticula
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