Home   Chapter Home   Jobs   Conferences   Fellowships   Books

Advertisement

Bladder

Urothelial benign lesions

Papillary hyperplasia

Reviewer: Andreas Gaumann, M.D. (see Reviewers page)
Revised: 9 February 2013, last major update June 2010
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

Definition
=========================================================================

● Asymptomatic lesion often found on routine follow-up cystoscopy of papillary urothelial neoplasms

Sites
=========================================================================

● 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 atypia
● 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)

Treatment
=========================================================================

● 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

Micro images
=========================================================================

   
Thicker urothelium which is thrown into undulating folds

   
Urothelium with multiple undulating folds yet no true papillary fibrovascular cores

   
Tall papillary folds

   
Thickened mucosa towards center of biopsy

   
Tent-like configuration of urothelium

Differential diagnosis
=========================================================================

● Low grade papillary urothelial neoplasm: has true papillary stalk (central fibrovascular core in an exophytic lesion; recommended to be aggressive in diagnosis in presence of known neoplasia)

End of Bladder > Urothelial benign lesions > Papillary hyperplasia

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).