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Bladder

Nonurothelial benign tumors

Fibroepithelial polyp


Reviewer: Monika Roychowdhury, M.D., University of Minnesota Medical Center (see Reviewers page)
Revised: 22 September 2012, last major update April 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Definition
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● Exophytic intraluminal mass of vascular connective tissue and variable inflammatory cells covered by normal urothelium

Epidemiology
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● Rare; usually reported in children
● In adults, male predominance, median age 44 years, range 17-70 years

Sites
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● Usually near verumontanum or bladder neck
● More common in proximal ureter than bladder

Etiology
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● Nonneoplastic

Clinical features
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● May be incidental / asymptomatic

Case reports
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● Boys ages 2 and 5 years (Pediatr Surg Int 2008;24:613)
● 3 year old boy with 15 cm polyp (Pediatr Dev Pathol 2003;6:179)
● 14 year old boy (Arch Ital Urol Androl 2005;77:118)

Treatment
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● Transurethral resection; donít recur

Clinical images
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Cystoscopy


Ureteral polyp

Micro description
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● Urothelial or rarely columnar epithelial lining
● Either (a) polypoid mass with cloverleaf-like projections and florid cystitis cystica et glandularis of nonintestinal type in stalk, (b) papillary tumor composed of numerous small, rounded fibrovascular cores containing dense fibrous tissue, or (c) polypoid lesion with secondary tall, finger-like projections (Am J Surg Pathol 2005;29:460)
● Broader stalks than papilloma; no prominent edema or inflammation
● May have degenerative stromal atypia (Arch Pathol Lab Med 1986;110:241)

Micro images
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With pseudocarcinomatous proliferation

   
Polyp of ureter

Differential diagnosis
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Florid cystitis cystica et. glandularis: not polypoid, no cloverleaf pattern
Inverted papilloma:anastomosing nests and cords growing downward
Polypoid or papillary cystitis: edematous, lacks prominent fibrous connective tissue in lamina propria, inflammatory infiltrate, often large areas of bladder involved
Urothelial papilloma: more papillary and less polypoid, narrower fibrous stalks, delicate loose fibroconnective tissue

End of Bladder > Nonurothelial benign tumors > Fibroepithelial polyp


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