Urothelial neoplasms-noninvasive
Papillary hyperplasia

Author: Andreas Gaumann, M.D. (see Authors page)

Revised: 5 August 2016, last major update June 2011

Copyright: (c) 2003-2016,, Inc.

PubMed Search: Bladder papillary hyperplasia
Cite this page: Papillary hyperplasia. website. Accessed October 25th, 2016.
Definition / General
  • Asymptomatic lesion often found on routine follow-up cystoscopy of papillary urothelial neoplasms
  • No predilection for site
Clinical Features
  • Appears to be a precursor lesion to papillary urothelial neoplasms, predominantly low grade lesions (Pathology 2010;42:360, Am J Surg Pathol 1996;20:1481)
  • In patient with prior urothelial neoplasm, may indicate early recurrence

  • Papillary hyperplasia with atypic
  • Architectural pattern of papillary hyperplasia with atypia of overlying urothelium
  • 80% male, age range 55 to 92 years
  • Atypia is usually due to flat carcinoma in situ (50%) or dysplasia (30%), and lesion is associated with CIS and high-grade papillary cancer (Hum Pathol 2002;33:512)
Prognostic Factors
  • Presence of atypia is poor prognostic factor (see above)
  • Follow up is indicated, particularly if history of urothelial neoplasm
Micro Description
  • Slight tenting, undulating or papillary growth lined by urothelium of varying thickness, without atypia
  • May also have tent-shaped broader folds
  • Often has small dilated capillaries at base, but no well defined fibrovascular core
  • Lacks discrete papillary fronds associated with papillary neoplasm
Differential Diagnosis