The case presented here illustrated the following features: the tumor was located in the anterior wall and in the bladder dome, the epicenter of the tumor was in the bladder wall, there was absence of cystitis cystica
or cystitis glandularis, and the investigations carried out did not reveal any primary tumor elsewhere, thereby fulfilling all the WHO criteria for the diagnosis of urachal adenocarcinoma.
Since the purpose of this study was to identify surface high-grade lesions and differentiate them from benign flat lesions, MPM diagnoses were clustered under 2 broad categories: (1) malignant lesions, including CIS and invasive high-grade urothelial carcinoma; and (2) benign lesions, which included all other flat lesions such as florid proliferation of von Brunn nests, cystitis cystica
et glandularis, atypia, hyperplasia, and others.
Role of cystitis cystica
et glandularis and intestinal metaplasia in development of bladder carcinoma.
The latter group also includes children with previously recorded urinary bacterial resistance, recurrent UTIs (>3 UTIs) and proven cystitis cystica
(endoscopically proven/US measurement >3.9 mm bladder wall thickness) (11).
Regardless of histologic pattern, cystitis cystica
et glandularis or surface glandular metaplasia is commonly present in the adjacent benign urothelium.
Ultrastructural observations on cystitis cystica
in human bladder urothelium.
The benign lesions include cystitis cystica
, cystitis glandularis, von Brunn nests, nephrogenic adenoma, mesonephric remnant, intestinal metaplasia, and urachal remnant.
Benign diverticular lesions usually involve inflammatory histologic changes, such as cystitis cystica
and cystitis glandularis, tissue granuloma and cellular atypia.[sup.8] Negative urine cytology in suspicious cases do not provide a good sensitivity to rule out urothelial cancers;[sup.9] moreover, both neoplastic and benign diverticula possess fibrovascular stromal tissues, such as fibroadipose tissue, which is usually found on the dense fibrous tissues that define the boundary between perivesical fat from the lamina propia.[sup.6] Therefore, the above-mentioned pathological tissue changes in intravesical diverticulum were all considered differential diagnoses in our case.
is a benign urothelial lesion characterized by the presence of cystically dilated von Brunn nests.
This variant of urothelial bladder cancer often resembles clinical and histological features of inverted papilloma, von Brunn's nests (VBNs), cystitis cystica
, nephrogenic metaplasia and sometimes usual TCC.
Irrespective of the various histologic patterns, there is usually evidence of cystitis cystica
et glandularis or surface glandular metaplasia in the adjacent benign urothelium.
et glandularis (CCEG) is a benign proliferative lesion of the bladder mucosa.[sup.1] Cystitis cystica
occurs when von Brunn's nests grow into the lamina propria forming cysts, while cystitis glandularis describes the metaplastic change into goblet cells.[sup.1] It is believed that CCEG is due to chronic irritation to the bladder epithelium, and do not usually cause symptoms.[sup.1]-[sup.4] However, few reported cases exist indicating that CCEG may obstruct the ureteral openings and cause hydronephrosis.[sup.3]-[sup.5] We report a rare case of CCEG where the mass caused obstruction and further complication by acute azotemia which required resection.