Molecular Genetics and Cancer Biology

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Benign Tumors of the Bladder

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Benign Tumors of the BladderEpithelial Metaplasia Leukoplakia Inverted Papilloma Papilloma Nephrogenic Adenoma Cystitis Cystica and Glandularis Leiomyoma

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Inverted Papilloma

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Inverted Papilloma•Rare, ~1% of urothelial neoplasms seen over a wide age range •Cystoscopy shows small (<3 cm) solitary sessile lesion or may have a short stalk. •Histology: ◦Urothelium invaginates into lamina propria (inverted). ◦Characterized by cords or trabeculae with peripheral palisading of basal cells and central streaming cells. ◦Cords should be thin (a must, to distinguish from higher grade inverted urothelial neoplasms). ◦Bland cytology, but may have scattered degenerative atypia. •Negligible recurrence rate (<1%).

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Inverted Papilloma

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Inverted PapillomaBenign proliferative lesion (associated with chronic inflammation or bladder outlet obstruction) Can be located throughout the bladder but most commonly on the trigone, comprising less than 1% of all bladder tumors Inverted growth pattern (anastomosing islands of histologically and cytologically normal urothelial cells invaginating from the surface urothelium into the lamina propria but not into the muscularis propria)

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Inverted PapillomaBehave in a benign fashion with only a 1% incidence of tumor recurrence. Occasionally, present with coexistent urothelial cancer elsewhere in the urinary system, occurring more commonly in the upper tract than the bladder The use of fluorescent in-situ hybridization (FISH) to evaluate chromosomal changes can distinguish between an inverted papilloma and a urothelial cancer with an inverted growth pattern (Jones et al, 2007). Transurethral resection is the treatment of choice.

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Last Updated: 8th March 2018

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