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Bladder
Bladder tumors - benign
Fibroepithelial polyp
Author: Nat Pernick, M.D.
Last revised: 28 June 2010, last major update June 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Exophytic intraluminal mass of vascular connective tissue and variable inflammatory cells covered by normal urothelium
Terminology
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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
Prognostic factors
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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, don’t recur
Clinical images
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Cystoscopy of fibroepithelial polyps prolapsing into the bladder from the right ureteral orifice
Ureteral polyp
Gross description (Macroscopy)
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Gross images
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Micro description (Histopathology)
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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 (Archives 1986;110:241)
Micro images
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With pseudocarcinomatous proliferation
Polyp of ureter
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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● 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
Additional references
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End of Bladder > Bladder tumors – benign > Fibroepithelial polyp
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