POLYPOID CYSTITIS: A FINDING AND DIFFERENTIAL DIAGNOSIS

Background. Polypoid cystitis may simulate urothelial neoplasias cystoscopically and histologically. The frequency of polypoid cystitis is 0.38%; that among patients undergoing bladder catheterization is 6 %.

Subjects and methods. The authors estimated the frequency of polypoid cystitis among chronic cystitis patients admitted to City Clinical Hospital Fifty, a base of the Clinic of Urology, Moscow State University of Medicine and Dentistry, in the period from February 2008 to February 2010. Out of 819 patients followed up, 3 who had diagnosed as having polypoid cystitis complained of pollakiuria, imperative micturate urges, and macrohematuria. They underwent ultrasonography, computed tomography, and cystoscopy; bladder masses measured 1.0, 7.0, and 11.5 cm, respectively; extensive growth was verified in 2 cases. Endoscopic studies identified procumbent rough-villous masses without well-defined outlines with the signs of bullous edema, decay, hemorrhages, and urinary salt encrustations. By taking into account the clinical picture and laboratory and instrumental findings, the authors suspected stage T3bNхMх bladder tumor in 2 patients and T1NхMх stage in 1. According to the European Association of Urology guidelines for management of bladder cancer, the patients underwent transurethral bladder resection. The patients were diagnosed as having polypoid cystitis on the basis of postmortem evidence.

Results. In this study the frequency of polypoid cystitis was 37 %. Polypoid cystitis, a benign mass without a risk for malignancy, had signs of invasive transitional cell carcinoma.

Conclusion. Such cases that rarely occur in practice are of clinical value and interest to urologists, pathologists, and oncologists.

1. Reuter V.E., Melamed M.R. The urotelial tract: Renal pelvis, ureter, urinary bladder and urethra. Diagn Surg Pathol 1999;2:1853–91.

2. Lane Z., Epstein J.I. A Series of 41 Cases Misdiagnosed as Papillary Urothelial Neoplasia. Am J Surg Pathol 2008;32(5):758–64.

3. Griffin N., Hamilton L., Shenoy M.D. et al. Polypoid cystitis in a child: a rare cause of hematuria. Brit Urol 2001;88(1):124.

4. Young R.H. Papillary and polypoid cystitis. A report of eight cases. Am J Surg Pathol 1988;12(7):542–6.

5. Waisman S.S., Banco J., Grourie W.J. Single polypoid cystitis cystica and glandularis presenting as benjgn bladder tumor. Urology 1990;36(4):364–6.

6. MacLennan G.T., Resnick M.I., Bostwick D.G. Pathology for Urologists. Saunders, 2003.

7. Petrisor Geavlete. Atlas of Endourology. Bucharest, 2006; p. 269–311.

8. Ekelund P., Anderstrom C., Johansson S.L. et al. The reversibility of catheterassociated polypoid cystitis. J Urol 1983;130(3):456–9.

9. Norlen L.J., Ekelund P., Hedelin H. et al. Effects of indwelling catheters on the urethral mucosa (polypoid urethritis). Scand J Urol Nephrol 1988;22(2):81–6.

10. Jakse G., Algaba F., Fossa S.et al. Pocket Guidelines. European Association of Urology. Gunnar Aus. Sweden, 2007; p.17.

11. Spitale L., Deangelis J.J., Bosio M.V. Eosinophilic polypoid cystitis with flat carcinoma in situ of the overlying epithelium. Arch Esp Urol 1989;42(8):809–11.

12. Goble N.M., Clarke T., Hammonds J.C. Histological changes in the urinary bladder secondary to urethral catheterisation. Br J Urol 1989;63(4):354–7.

13. Давыдов М.И., Аксель Е.М. Статистика злокачественных новообразований в России и странах СНГ в 2005 г. Вестник Российского онкологического научного центра им. Н.Н. Блохина. 2007. Т. 18, прил. 1, с. 58–9.

14. Black R.J., Bray F., Ferlay J. et al. Сancer incidence and mortality in the European Union. Eur J Cancer 1997;33:1075–107.

15. Borden L.S., Clark P.E., Hall M.C., Bladder Cancer. J Curr Opin Oncol 2003;15: 227–33.

16. Шатов А.В., Березуцкий Н.Т. Сравнительная оценка роли РКТ и МРТ в диагностике и лечении опухолей мочевого пузыря. Тез. докл. Пленума Всерос общества урологов. Кемерово, 1995; с. 289–99.

17. Neueburg J.M., Bohndorf K., Sohn M. et al. Staiging of urinary bladder neoplasms with MRI. Is GD PTPA helpful? J Comput Assist Tomogr 1991;15:780–6.

18. Воробьев А.В. Классификация и диагностика рака мочевого пузыря, вопросы дифференциальной диагностики. Практ онкол 2003;4(4):196–203.