CASE OF THE WEEK
2019-28 / AUGUST 26
(CONTRIBUTOR: SOUNAK GUPTA)
Representative images of transurethral resections of bladder tumors taken from a 33-year-old male have been depicted.
Quiz
1. What is the correct diagnosis?
a. Cystitis glandularis
b. Cystitis glandularis with low grade dysplasia
c. Cystitis glandularis with high grade dysplasia
d. Mucinous adenocarcinoma
1. b
1. Cystitis glandularis with low grade dysplasia
Microscopically, the lesion exhibits numerous glands-like spaces lined by intestinal type epithelium, with extensive extravasation of mucin and no epithelial cells are seen floating within the mucin pools. Most of the cells lining the intestinal type glands are cytologically bland consistent with typical cystitis glandularis with intestinal metaplasia. However, there are focal areas of glands showing adenomatous atypia with a few mitotic figures.
Based on these morphological findings, this lesion is best classified as florid cystitis glandularis of intestinal type with mucin extravasation and foci of at least low-grade dysplasia. No evidence of overt adenocarcinoma is noted.
Gordetsky J, Epstein JI. Intestinal metaplasia of the bladder with dysplasia: a risk factor for carcinoma?
Histopathology. 2015 Sep;67(3):325-30.
Sounak Gupta
Mayo Clinic, Rochester
Gupta.sounak@mayo.edu
Bladder
Cystitis glandularis, dysplasia, bladder