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Bladder
Cystitis
Polypoid / papillary cystitis
Author: Nat Pernick, M.D. (see Authors page)
Revised: 24 December 2009, UPDATE IN PROGRESS
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Definition
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● Chronically inflamed bladder with grossly noted polypoid lesions (with edema) or papillary lesions
Terminology
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● May overlap with bullous cystitis
Epidemiology
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● Rare, mean age 49 years, 75% male
Sites
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Etiology
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● Due to injury to bladder mucosa; papillary cystitis is chronic phase of polypoid cystitis
Clinical features
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● Often due to bladder catheterization, although not always (Int Urol Nephrol 2002;34:293); more common/severe with frequent catheterization
● Also associated with Beckwith-Wiedemann syndrome, radiation therapy
Prognostic factors
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Case reports
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● 41 year old woman with ovarian abscess (Int Urogynecol J Pelvic Floor Dysfunct 2007;18:579)
Treatment
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● Remove source of injury
Clinical images
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Gross description (Macroscopy)
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● Bullous, polypoid or papillary lesions in dome or posterior bladder wall
Gross images
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Micro description (Histopathology)
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● Low power diagnosis – must recognize reactive nature of process with inflamed background and urothelium of normal thickness (Am J Surg Pathol 2008;32:758)
● Thin, finger-like papillae or broad based polypoid lesions with congestion and edema of lamina propria
● Mild chronic inflammatory infiltrate
● Reactive fibroblasts may appear bizarre
● Covered by normal appearing or metaplastic urothelium with orderly maturation and surface umbrella cells (AJSP 1988;12:542)
● May have reactive epithelial atypia
● No hyperchromasia, no coarse chromatin, no abnormal mitotic figures
Micro images
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Papillary cystitis
Polypoid cystitis
No thumbnail: #1
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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● Papillary urothelial carcinoma: At low power and cystoscopy, appears neoplastic and not inflammatory; prominent atypia present
Additional references
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End of Bladder > Cystitis > Polypoid / papillary cystitis
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