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Bladder

Acquired non-neoplastic anomalies

Endosalpingiosis

Reviewer: Alcides Chaux, M.D., Johns Hopkins University School of Medicine (see Reviewers page)
Revised: 3 July 2011, last major update April 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Definition
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● Involvement of lamina propria and muscularis propria by tubules and cysts with tubal-type epithelium (ciliated cells, intercalated cells, peg cells)

Terminology
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● Called mullerianosis if two of three related entities (endocervicosis, endometriosis or endosalpingiosis) are present (Mod Pathol 1996;9:731)

Epidemiology
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● Very uncommon
● Usually seen in women of childbearing age

Sites
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● Posterior wall or posterior dome

Etiology
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● Metaplastic (mullerian metaplasia) or implantative (similar to endometriosis)

Clinical features
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● Suprapubic pain, urinary frequency, dysuria
● May occur after surgery in some cases

Case reports
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● 54 year old woman with pure endosalpingiosis, possibly implanted after surgery (Int J Surg Pathol 2010;18:381)

Treatment
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● Excision; may recur (Urology 2004;64:1031)

Gross description (macroscopy)
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● May form mass on posterior wall of bladder

Micro description (Histopathology)
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● Involvement of lamina propria and muscularis propria by tubules and cysts of mullerian-type epithelium
● May replace urothelium and form polypoid projections into bladder lumen
● Tubules and cysts are round/oval, may have prominent branching
● Glands are lined by tubal type epithelium (ciliated cells, intercalated cells, peg cells)
● No atypia, no mitotic figures, no necrosis

Micro images
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Uterine serosal lesion: glands lined by tubal type epithelium


Ovary: glands lined by ciliated epithelium lie in fibrous stroma


Ovary: ciliated, secretory and intercalated cells line the cystic space


Ovary: glands lined by tubal type epithelium

Differential diagnosis
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● Adenocarcinoma: marked atypia, invasive borders, usually not ciliated and lacks 3 types of tubal cells

End of Bladder > Acquired non-neoplastic anomalies > Endosalpingiosis

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