Polypoid Cystitis Research Articles

Benign urinary bladder masses: rare entities

BackgroundThis study aimed to present the characteristics and outcomes of benign urinary bladder masses, as well as the characteristics of the patients diagnosed with such lesions.MethodsA single-center, cross-sectional, retrospective study was conducted. The study involved patients who underwent transurethral resection of the primary bladder tumor over a four-year period (May 2017–2021) and were subsequently diagnosed with a benign bladder lesion.ResultsOut of 478 patients who underwent transurethral resection of the primary bladder tumor, 26 (5.4%) were diagnosed with a benign bladder lesion. The most common benign bladder lesion was urothelial papilloma (50%, 13 patients). The majority of patients with urothelial papilloma were men (76.9%) and had a history of smoking (61.5%). The mean age was 62 years. Most were diagnosed accidentally (69.2%), while others presented with hematuria (23.1%) or dysuria (7.7%). Most urothelial papillomas had a macroscopic polypoid appearance (61.5%), and most of them were solitary (84.6%), with a mean size amounting to 1 cm. Only one patient experienced a recurrence and developed papillary urothelial neoplasm of low malignant potential (PUNLMP). Cystitis cystica/glandularis and polypoid cystitis were the second most commonly diagnosed benign bladder lesion, each identified in 3 patients. Singular cases of leiomyoma, inflammatory myofibroblastic tumor, chondroma, paraganglioma, villous adenoma, eosinophilic cystitis (pseudotumor), and ectopic prostatic tissue are described.ConclusionBenign bladder lesions constitute a group of various rare entities that can clinically and radiologically mimic urothelial carcinoma, but mostly show a good prognosis and a low incidence of recurrence.

Ultrasonographic diagnosis of polypoid cystitis with struvite crystals in a Shih Tzu dog

A seven-year-old un-castrated male Shih Tzu dog was presented with signs of in appetence and dysuria for ten days. Abdominal ultrasonography noticed multiple mucosal projections, isoechoic with a mildly thickened bladder wall and sledge in the urinary bladder. Urine analysis revealed a pH of 8.5, specific gravity of 1.050, struvite crystals and microbial culture yielded Staphycolocci and Pseudomonas. Present communication about the rare documentation of polypoid cystitis which was diagnosed by abdominal ultrasonography.

Bladder Postoperative Spindle Cell Nodule: Malignant Mimicry in the Postoperative Setting

Bladder Postoperative Spindle Cell Nodule: Malignant Mimicry in the Postoperative Setting

Polypoid Cystitis in a dog. A case report.

ABSTRACT. Polypoid cystitis is a rare disease of younger male dogs. The aim of this article is to report an incidence of polypoid cystitis, which was observed in a dog. The 11-year-old dog had a 3-month history of hematuria. Upon surgical approach to the retroperitoneal area an irregularly thickened wall was revealed, and additionally six (6) cysts 1-6 mm in diameter protruded from the mucosal surface. Histological examination confirmed transitional cell hyperplasia covering a core of proliferating connective tissue, edema and a neutrophilic inflammatory cell infiltrate with areas of ulceration and hemorrhage. These lesions are consisted with polypoid cystitis which is is a rare-benign disease, histopathology is the means of definitive diagnosis and it is best treated with surgical cystotomy.

Polypoid cystitis in dogs and cattle

This datasheet on polypoid cystitis in dogs and cattle covers Identity, Hosts/Species Affected, Diagnosis.

Incidental diagnosis of nonfunctional bladder paraganglioma: a case report and literature review

BackgroundNonfunctional bladder paragangliomas is a rare urological disease. It may present clinical, radiology and pathological features similar to bladder cancer, Only scarce reports have been reported. Urologist must identify this generally benign neuroendocrine neoplasm to avoid misdiagnosis.Case presentation A 62-year-old female presented the outpatient department of our hospital with the symptoms of stomachache, frequent micturition, and urination pain for 20 days. Diagnosed with high blood pressure 1 year ago, administered Amlodipine besylate tablets 5 mg po qd occasionally, did not check blood pressure; denied any tumor observation in the family history. Color ultrasound of the urinary system showed a 38 mm × 34 mm hypoechoic mass on the right side of the bladder, CDFI: in the masses, blood supply was sufficient. Cystoscope showed bladder occupying lesion. Biopsy diagnosis: papillary polypoid cystitis was suspected as a malignant change (Fig. 3a). Then, the patient was admitted to our urological department. Further, computer tomography urography considered bladder cancer. Cystoscopy and biopsy failed to define the nature of the lesions in our outpatient department, which prompted a transurethral resection of the bladder tumor. histopathological and immunohistochemical results were diagnosed as bladder paragangliomas. For the reason, the tumor was removed by partial resection of the bladder. The postoperative recovery and follow-up were uneventful.ConclusionsNonfunctional bladder paragangliomas are occasionally found on imaging studies with the symptoms of urinary tract infection or/and intermittent painless hematuria. It may present clinical, radiology and pathological features similar to bladder cancer, so knowledge of this generally benign neuroendocrine neoplasm is of great importance to avoid misdiagnosis. It should be accompanied by the clinical and pathological characteristics of the patient and image changes. Partial resection of the bladder can effectively treat this disease.

Mimickers of Urothelial Carcinoma and the Approach to Differential Diagnosis.

A broad spectrum of lesions, including hyperplastic, metaplastic, inflammatory, infectious, and reactive, may mimic cancer all along the urinary tract. This narrative collects most of them from a clinical and pathologic perspective, offering urologists and general pathologists their most salient definitory features. Together with classical, well-known, entities such as urothelial papillomas (conventional (UP) and inverted (IUP)), nephrogenic adenoma (NA), polypoid cystitis (PC), fibroepithelial polyp (FP), prostatic-type polyp (PP), verumontanum cyst (VC), xanthogranulomatous inflammation (XI), reactive changes secondary to BCG instillations (BCGitis), schistosomiasis (SC), keratinizing desquamative squamous metaplasia (KSM), post-radiation changes (PRC), vaginal-type metaplasia (VM), endocervicosis (EC)/endometriosis (EM) (müllerianosis), malakoplakia (MK), florid von Brunn nest proliferation (VB), cystitis/ureteritis cystica (CC), and glandularis (CG), among others, still other cellular proliferations with concerning histological features and poorly understood etiopathogenesis like IgG4-related disease (IGG4), PEComa (PEC), and pseudosarcomatous myofibroblastic proliferations (post-operative spindle cell nodule (POS), inflammatory myofibroblastic tumor (IMT)), are reviewed. Some of these diagnoses are problematic for urologists, other for pathologists, and still others for both. Interestingly, the right identification of their definitory features will allow their correct diagnoses, thus, avoiding overtreatment. The literature selected for this review also focuses on the immunohistochemical and/or molecular data useful to delineate prognosis.

Prognostic role of ΔNp63 expression in canine transitional cell carcinoma of the urinary bladder.

Background:Decreased p63 protein expression in canine transitional cell carcinoma (TCC) of the urinary bladder is associated with vascular invasion of the tumor, metastasis, and shortened survival. ΔNp63, an isoform of p63, is downregulated in high-grade invasive urothelial carcinoma in humans. However, the clinical significance of ΔNp63 expression in canine urinary bladder tumors is unknown. Therefore, it is essential to investigate ΔNp63 expression patterns in TCC, the most common urinary bladder tumor in dogs.Aim:This study aimed to evaluate the expression and role of ΔNp63 in canine TCC of the urinary bladder.Methods:ΔNp63 expression was compared between the normal canine urinary bladder, polypoid cystitis, and TCC. The correlation of ΔNp63 expression with histopathological and clinical findings were further evaluated, and its usefulness as a prognostic factor was examined.Results:We observed that ΔNp63 was highly expressed in dogs’ normal urinary bladder and polypoid cystitis, and its expression levels were low in TCC. Furthermore, low levels of ΔNp63 expression were associated with vascular invasion, metastasis, and shortened survival in dogs with TCC.Conclusion:These results indicate that ΔNp63 expression could serve as a valuable biomarker for invasion, metastasis, and prognosis of canine TCC of the urinary bladder.

A Rare Case of Polypoidal Cystitis in Adult without History of Prolong Catheterization

Introduction: Polypoidal cystitis is a rare lesion of the bladder mucosa characterized by benign exophytic inflammation,epithelial proliferation and development of polypoid mass without evidence of neoplasm histologically. Polypoid cystitis is rarely seen in patient without prolong used of indwelling catheter. Other cases of polypoidal cystitis are associated with post-radiation, post chemotherapy bladder reaction, colovesicular fistula are extremely rare. Case Report: 66 year old Malay male ,underlying hypertension and Benign Prostatic Hyperplasia (BPH) on treatment, complaining of difficulty in urination, straining on voiding for the past 6 months and on and off  hematuria for the past 2 months. He denied any history of CBD insertion or prolong cataheterization. Blood investigations are Normal. X-Ray KUB showed unremarkable. Ultrasound KUB revealed Prostatomegaly, no evidence of renal or ureteric calculi or evidence of Obstructive uropathy,No obvious bladder mass. Cystoscopy Examination (CE) showed enlarged occlusive prostate and noted bladder growth at base of bladder. The growth is malignant looking however no active bleeding seen. No bladder stone seen. Patient subsequently underwent TransUrethral Resection of Bladder Tumor (TURBT) and Trans-Urethral Resection of Prostate (TURP) in same setting. Intra operatively was uneventful. HistoPathological Examination (HPE) from TURBT specimens showed in favour of Polypoidal Cystitis and TURP revealed Nodular Hyperplasia. Discussion: Polypoidal Cystitis is a form or chronic cystitis characterized by exophytic inflammatory  lesion of bladder mucosa. The polypoidal mass is mimicking neoplasm. At the initial evaluation, it may be confused with transitional cell carcinoma of the urinary bladder, especially in patient without an indwelling catheter. The most common aetiology of this condition is long-standing indwelling catheterization.. There is also reported that any factors that irritates the bladder mucosa may result in Polypoidal Cystitis.  In our patient ,there was no history of such other causes, including prolong catheterization, fistula, urinary calculi or radiation therapy.

ErbB2 Copy Number Aberration in Canine Urothelial Carcinoma Detected by a Digital Polymerase Chain Reaction Assay.

Urothelial carcinoma (UC) is the most common tumor affecting the urinary bladder of dogs. Protein overexpression of ErbB2 (the canine homolog of HER2) has been observed in dogs with UC. However, no study regarding ErbB2 copy number aberration (CNA) is reported in dogs with UC. In this study, a digital PCR assay for detecting CNA of canine ErbB2 was developed. DNA samples were isolated from 83 formalin-fixed, paraffin-embedded urinary bladder tissues (36 UC, 8 polypoid cystitis, and 39 normal) and 94 urinary sediments (54 UC, 30 nonneoplastic, and 10 normal). The copy number of canine chromosome 8 (CFA8) was used as a control. In the urinary bladder tissues, ErbB2 CNA was detected in 12 of 36 (33%) UC, 2 of 8 (25%) polypoid cystitis, and 0 of 39 (0%) normal controls. In the urinary sediments, ErbB2 CNA was also detected in 19 of 54 (35%) UC; however, no ErbB2 CNA was detected in nonneoplastic diseases or normal controls. The sensitivity and specificity of ErbB2 CNA in urinary sediment for the detection of UC were 35% and 100%, respectively. There was a positive correlation between the copy number ratios of ErbB2 to CFA8 in the urinary bladder tissues and urinary sediments. Our findings indicate that the digital PCR assay of urinary sediments may be a useful, noninvasive method for detecting ErbB2 CNA in dogs with UC.

Assessment of HER2 Expression in Canine Urothelial Carcinoma of the Urinary Bladder.

Canine urothelial carcinoma (UC) has a poor prognosis and high metastatic rate. Human epidermal growth factor receptor 2 (HER2), a receptor tyrosine kinase involved in cell proliferation and differentiation regulation, has been attracting interest as a therapeutic target molecule for human breast cancer. This study investigated expression of the canine homolog of HER2 (ERBB2) in canine UC, and its association with clinical factors. Since it has been controversial whether commercial anti-human HER2 antibody (Dako A0485) correctly recognizes the canine homolog of HER2, an application of the antibody using a canine UC cell line was validated first. By Western blot, a single band at the appropriate size for canine HER2 (185 kDa) was recognized. Immunohistochemistry for HER2 was performed on 23 samples of UC, 8 samples of polypoid cystitis, and 8 samples of normal urinary bladder, and the results were scored as either 0, 1+, 2+, or 3+ with reference to the evaluation method for human UC. Intense membranous HER2 immunoreactivity was frequently observed in neoplastic cells, especially in grade 2 UC. Minor HER2 expression was found in the epithelial cells of polypoid cystitis and normal bladder. The incidence of HER2 positivity (scores of 2+ or 3+) was 14 of 23 (60.9%) in UC, 3 of 8 (37.5%) in polypoid cystitis, and 0 of 8 (0%) in normal bladder. There was no significant correlation between HER2 positivity and clinical factors. While increased HER2 expression was observed in a subset of urothelial carcinomas, further mechanistic studies are needed to determine its role in the pathogenesis and targeted therapy of this cancer.

Polypoid cystitis in a 3-year-old child: A rare occurrence

Polypoid cystitis is a rare, benign, reactive, exophytic urinary bladder mucosal lesion whose etiology has been attributed to chronic non-specific injury to bladder mucosa. It is most commonly seen in patients with indwelling catheter. It is a recognized mimic of bladder neoplasms. The findings at imaging studies are not well known. We report a case in a three years old child who presented with a severe form of the disease on a background of resistant E. coli infection. The patient was treated with antibiotics, and surgical resection of the mass and patient has been on follow-up since. The present case is notable in that it occurred in a child with no known predisposing factor except for history suggestive of recurrent bacterial urinary tract infection.

Pathological Outcomes for Patients Who Failed To Remain Under Active Surveillance for Low-risk Non–muscle-invasive Bladder Cancer: Update and Results from the Bladder Cancer Italian Active Surveillance Project

BackgroundIt has been shown that active surveillance (AS) is feasible and effective in a subset of patients with recurrent low-grade (LG) non–muscle-invasive bladder cancer (NMIBC). ObjectiveTo update a previous preliminary series and investigate pathological outcomes for patients who failed to remain on AS. Design, setting, and participantsProspective observational cohort study started in February 2008, and currently still active, at a tertiary university hospital, including patients with pathologically confirmed NMIBC who experienced recurrence during follow-up. InterventionAS monitoring consisted of cytology and in-office flexible cystoscopy every 3 mo for the first year, and every 6 mo thereafter. Outcome measurements and statistical analysisThe primary endpoint was pathological results for patients who failed to remain on AS. The secondary outcome was an update of clinical results from our previous series. Data were complemented by descriptive statistical analysis and univariable and multivariable proportional hazards Cox regression. Results and limitationsOverall, 167 patients were included. Of 181 AS events, 61 (33.7%) were deemed to require treatment because of positive cytology (n=10), gross haematuria (n=11), and increases in the tumour number (n=15), or size (n=17), or both (n=8). The median time on AS was 12 mo (interquartile range 4–26). Pathological specimens from AS failures did not show any malignancy in 20 cases. Histopathology identified urothelial hyperplasia and oedema, submucosal vascular ectasia, mucosal erosion, polypoid cystitis, von Brunn nest hyperplasia, and squamous metaplasia. The time from first transurethral resection to AS start was inversely associated with recurrence-free survival (hazard ratio 0.97, 95% confidence interval 0.96–1.00; p=0.024). The study lacks statistical subanalyses focusing on patients with failure and negative neoplastic pathological outcomes. ConclusionsAS might be a reasonable strategy in patients presenting with small LG pTa/pT1a recurrent bladder tumours. Approximately 30% of patients deemed to have AS failure did not harbour any neoplastic lesion, strengthening the role of AS. Patient summaryPatients with small low-grade pTa/pT1a recurrent papillary bladder tumours could benefit from an active surveillance protocol with no significant risk of pathological progression to muscle-invasive cancer.

Polypoid cystitis as a cause of haematuria in a pony mare

SummaryA 15‐year‐old pony mare was presented for investigation of haematuria of 2 weeks' duration. On cystoscopy, multiple small pedunculated soft tissue structures were observed on the bladder mucosa. Histopathological analysis of the masses was consistent with chronic polypoid cystitis. The polypoid lesions and associated haematuria resolved following prolonged antibiotic treatment. Polypoid cystitis has not previously been described in horses. This condition should be considered a differential for haematuria, requiring cystoscopy and biopsy to confirm a diagnosis.

Cystoscopic diagnosis of polypoid cystitis in two pet rabbits.

CASE DESCRIPTION AS-year-old male Dwarf rabbit and 4-year-old female Mini-Rex rabbit were evaluated because of anorexia and urine scalding of the perineum. CLINICAL FINDINGS Abdominal radiography revealed a diffuse increase in the opacity of the urinary bladder attributable to urinary sludge. In 1 rabbit, abdominal ultrasonography revealed several mass-like lesions protruding from the mucosal surface into the lumen of the urinary bladder. Rabbits were anesthetized, and cystoscopy was performed with a rigid 2.7-mm, 30° endoscope. Histologic analysis of tissue samples obtained through the cystoscope operating channel revealed findings consistent with polypoid cystitis. TREATMENT AND OUTCOME To remove the urinary sludge from each rabbit, the urinary bladder was filled with sterile saline (0.9% NaCl) solution and emptied with a gentle massage several times until the ejected fluid was transparent. Rabbits were treated with NSAIDs, antimicrobials (chosen following microbial culture of urine and antimicrobial susceptibility testing), bathing of the perineum, and a low-calcium diet. The male rabbit died of unrelated causes 18 months later; postmortem examination findings confirmed the polypoid cystitis. The female rabbit remained disease free through to last follow-up (12 months after initial evaluation). CLINICAL RELEVANCE This was the first report of polypoid cystitis in pet rabbits. Although ultrasonographic findings supported this diagnosis, a definitive diagnosis was achieved through cystoscopy and lesion biopsy. Treatments administered were intended to reduce the potential sources of irritation. Research is needed to investigate the effectiveness of the applied interventions and the association between excessive urinary calcium excretion and polyploid cystitis in rabbits.

Bladder Mass in Newborn: Case Report and Review of Literature

Benign proliferative lesions of the bladder are exceptional in neonates. We describe a case of a 3-day-old neonate, presenting with bloody meconium and sonographic diagnosis of bladder mass. Cystoscopic biopsies were performed and a diagnosis of polypoid cystitis was made. The patient was treated conservatively and the lesion healed during follow-up. We review the literature of other cases of neonatal bladder masses.

Epidermal growth factor receptor expression in canine transitional cell carcinoma.

Transitional cell carcinoma (TCC), a urinary bladder tumor with high mortality, is encountered commonly in dogs. Whereas overexpression of epidermal growth factor receptor (EGFR) is associated with development of human urinary bladder cancer, information on EGFR expression in canine TCC is lacking. In this study, EGFR protein and mRNA expression in canine normal bladder (n=5), polypoid cystitis (n=5) and TCC (n=25) were examined by immunohistochemistry and real-time polymerase chain reaction. EGFR protein expression was significantly higher in TCC than that in normal healthy bladder (P<0.001) and polypoid cystitis (P<0.005). High EGFR protein expression was significantly (P<0.01) associated with TCC with a sensitivity of 72% and specificity of 100%. Comparative analysis of protein and mRNA expression levels in TCC showed significant positive correlation (r=0.88, P<0.05) between mRNA and protein expression. These findings suggest that intense expression of EGFR protein could be used as a marker to help canine TCC diagnosis.

Immunohistochemical expression of p63, Ki67 and β-catenin in canine transitional cell carcinoma and polypoid cystitis of the urinary bladder.

Transitional cell carcinoma (TCC) is a urinary bladder tumour associated with high mortality in dogs. In this study, we investigated the feasibility of using p63, Ki67 or β-catenin as a clinical marker for predicting biological behaviour and prognosis in canine TCC. Expression levels of these proteins in TCC (n = 25), polypoid cystitis (n = 5) and normal urinary bladder (n = 5) were scored after immunohistochemical staining. The staining scores for p63 (P < 0.01) and β-catenin (P < 0.05) in TCC were significantly lower than those in normal urinary bladder and polypoid cystitis. In contrast, Ki67 (P < 0.01) staining scores in TCC were significantly higher than those in normal urinary bladder and polypoid cystitis. In TCC, low p63 expression was significantly related to the presence of vessel invasion (P < 0.05) and metastasis (P < 0.01) as well as short survival time (P < 0.05). These findings show that p63 could be a reliable marker for predicting prognosis in canine TCC.

Polypoid cystitis in a three year old child: does microbial inflammation play a role in the aetiology of this disease?

<h3>Introduction</h3> Polypoid cystitis is a rare, benign, exophytic urinary bladder mucosal lesion with gross polypoid-papillary appearance, and characterized histologically by normal or mildly hyperplastic urothelium overlying an oedematous, chronically inflamed stroma. Aetiology is attributed to bladder mucosal inury; commonly in adults with indwelling catheter. It may, from the standpoint of clinical manifestation, imaging, cystoscopy and cytology, simulate urothelial neoplasm. The present case is rare in that it occurred in a child with no known predisposing factor except for history of recurrent bacterial UTI. <h3>Patient</h3> A 3-year-old boy presented to our hospital with 3 months history of recurrent painful micturition and subsequently haematuria, necroturia and obstructive and irritative lower urinary tract symptoms with progressive suprapubic swelling. General examination revealed pallor and weight loss. Ultrasonography and CT-scan showed a huge exophytic polypoid mass attached to the base and anterior wall of the bladder with bilateral upper tract dilatation. Urine cultures were positive for Escherichia coli. Histology of transurethral biopsy established a diagnosis of polypoid cystitis. Intra-operative findings were of a huge mass taking up almost the entire bladder and extending into the prostatic urethra which were excised. The child has done very well since. <h3>Conclusion</h3> Polypoid cystitis may occur in the absence of all the recognised predisposing factors but it remains to be established whether microbial inflammation does also provoke it.

ULTRASONOGRAPHIC FINDINGS RELATED TO PROGNOSIS IN CANINE TRANSITIONAL CELL CARCINOMA

In human bladder cancer patients, ultrasonography is extensively used not only to identify tumor masses but also to evaluate tumor size, shape, echogenicity, location, and degree of tumor invasion into the bladder wall. The information revealed by ultrasonography delineates the tumor's biological features and facilitates prediction of prognosis. However, in veterinary medicine the feasibility of using ultrasonography for these purposes has not been fully investigated. In this retrospective study, we reviewed cases of dogs with histologically confirmed bladder mass lesions, including transitional cell carcinoma (n = 22) and polypoid cystitis (n = 5), to determine whether ultrasonography could reliably predict bladder wall involvement. By following patients with transitional cell carcinoma until death, we also determined whether ultrasonographic tumor size, shape, echogenicity, and mass location were related to prognosis. Wall involvement as revealed by ultrasound was significantly (P = 0.00005) associated with histological muscular layer involvement with a sensitivity of 93% (95% Confidence interval, 79-98%) and specificity of 92% (95% Confidence interval, 76-98%). Ultrasonographic wall involvement (P = 0.03, vs. noninvolvement), heterogeneous mass (P = 0.02, vs. homogeneous mass), and trigone location (P = 0.01, vs. other locations) characteristics were significantly associated with shorter survival times in transitional cell carcinoma cases. Findings indicated that ultrasonographic characteristics such as wall involvement, heterogeneous mass, and trigone location could be reliable prognostic indicators in canine transitional cell carcinoma.