Inflammatory Pseudotumor Of Urinary Bladder Research Articles

Inflammatory pseudotumor of urinary bladder: A masquerader of bladder malignancy

Inflammatory pseudotumor of urinary bladder is a rare benign disease of unknown etiology, characterized by nonneoplastic proliferation of fibroblastic spindle cells, in a background of myxoid and granulation tissue. We report a case of an inflammatory pseudotumor of urinary bladder and discuss the important differentials. A 47-year-old woman presented with longstanding frequency and urgency of micturition. Ultrasound pelvis, color Doppler, computed tomography, and magnetic resonance imaging were performed. Focal bladder wall thickening at the dome was observed. In addition, there was a heterogeneous solid cystic intramural lesion within this bladder wall thickening showing peripheral rim enhancement with nonenhancing central component. Repeated urine cultures were sterile and urine cytology was found to be negative for malignancy. Finally, histopathology and immunohistochemistry confirmed this lesion to be inflammatory pseudotumor.

Immunoglobulin G4–associated inflammatory pseudotumor of urinary bladder: a case report

A previously healthy 72-year old woman was admitted with a chief complaint of gross hematuria and fecaluria for 4 months. On initial computed tomographic examination, a lobulated shaped intravesical protruding mass with adhesion to the sigmoid colon was identified. Under a clinical diagnosis of bladder cancer with vesicosigmoid fistula vs sigmoid colon cancer with vesicosigmoid fistula, a frozen section evaluation of the bladder mass was performed to determine the origin of the tumor. Because the frozen section diagnosis of the bladder mass was an inflammatory origin, a partial cystectomy with segmental resection of the adherent sigmoid colon was elected. The microscopic examination of the partial resection of the urinary bladder revealed suburothelial inflammatory mass lesion, involving the entire wall of bladder with extension to the sigmoid colon, which was composed of spindle cells without significant atypia admixed with many lymphocytes, plasma cells, and some scattered eosinophils. Chronic inflammation around nerve bundles, sclerotic fibrosis, and prominent lymphoid follicles with plasma cells were the main features of the mass. No urothelial dysplasia or malignancy was seen. An average of 57 plasma cells per 1 high-power field was immunoreactive for immunoglobulin (Ig) G4 with IgG4/IgG ratio of more than 40%, a diagnostic feature of IgG4-associated inflammatory pseudotumor (IPT), arising in the bladder with the secondary involvement of the sigmoid colon. Recent studies reported many IPTs associated with IgG4 in other locations; however, to the best of our knowledge, IgG4-associated IPT in the urinary bladder has not been reported. We describe herein the first case of IgG4-associated IPT, lymphoplasmacytic type in the urinary bladder.

Inflammatory pseudotumor of urinary bladder – a diagnostic and management dilemma

Inflammatory pseudotumors (IPT) are uncommon, benign, non-epithelial tumors of the urinary bladder. Only less than 30 cases have been reported so far in world's literature. The transititional cell carcinoma constitutes 90% of malignant epithelial tumors of urinary bladder. Large, endoscopically unresectable tumors require radical surgery. IPT resemble such tumors, morphologically, radiologically and clinically. The benign nature of this tumor warrants conservative surgical management, either transurethral resection or partial cystectomy. Awareness of this entity and its inclusion in the differential diagnosis may prevent unnecessary radical surgery. We report an unusual case of inflammatory pseudotumor of urinary bladder because of its diagnostic and management dilemma.