Bladder, ureter & renal pelvis

Urothelial neoplasms - noninvasive

Papillary hyperplasia

Last author update: 1 June 2011
Last staff update: 11 November 2021

Copyright: 2003-2022,, Inc.

PubMed Search: Bladder papillary hyperplasia

Andreas Gaumann, M.D.
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Cite this page: Gaumann A Papillary hyperplasia. website. Accessed December 9th, 2022.
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
Microscopic (histologic) 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
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