Bladder - Pseudocarcinomatous epithelial hyperplasia

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Bladder

Pseudocarcinomatous epithelial hyperplasia

Author: Nat Pernick, M.D., PathologyOutlines.com, Inc.
Revised: 30 June 2011, last major update June 2011
Copyright: (c) 2011, PathologyOutlines.com, Inc.

Definition
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● Rare reactive condition that resembles carcinoma, initially described post-radiation (Hum Pathol 2000;31:678, Am J Surg Pathol 2004;28:909), but also associated with ischemia and chronic radiation (Am J Surg Pathol 2008;32:92)

Clincal features
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● Associated with radiation therapy; also ischemia and chronic irritation
● No treatment is required for this reactive condition

Case reports
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● 55 year old woman with hematuria (Case of the Week #198)

Micro description
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● Downward proliferation of urothelial pseudoinvasive nests with focal squamous metaplasia but without atypia
● Nests wrap around vessels with fibrin deposition and congestion
● May have retraction artifact
● These nests, especially because of their irregular shape, can resemble invasive carcinoma; however, morphology is not typical of early invasive urothelial carcinoma
● Frequently hemorrhage, thickened vessels and other radiation associated vascular changes are present
● Fibrin deposition, fibrin thrombi, fibrosis, inflammation, hemosiderin, ulceration, edema and vascular congestion
● No mitotic figures

Micro images
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Case of the Week #198

Pseudocarcinomatous proliferation related to radiation therapy

Additional references
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● Mod Pathol 2009;22:S37, Open Pathol J 2009;3:74, Arch Pathol Lab Med 2010;134:427

End of Bladder > Pseudocarcinomatous epithelial hyperplasia of the urinary bladder

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