MRI Findings of Inverted Urothelial Papilloma of the Bladder

Takeuchi, Mitsuru; Sasaguri, Kohei; Naiki, Taku; Mitsumori, Akihito; Ito, Hirotoshi; Takahama, Junko; Yamada, Kaori; Marugami, Nagaaki; Tsuboyama, Takahiro; Okumura, Yoshihiro; Ohgiya, Yoshimitstu; Kawai, Noriyasu; Kohri, Kenjiro; Shibamoto, Yuta

doi:10.2214/ajr.14.13879

Cited by 10 publications

(9 citation statements)

References 24 publications

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“…11,17 Magnetic resonance imaging (MRI) typically shows a polypoid lesion with a non-papillary surface, a thin short stalk, and occasional cystic foci. 10 IUP tends to be isointense on T1-weighted images and either isointense or slightly higher in intensity than the wall of the bladder on T2-weighted images. These lesions can also restrict diffusion on diffusion weighted MRI, similar to UC.…”

Section: Imagingmentioning

confidence: 93%

“…6,7 IUP has been found in patients ranging from 20-89 years of age, with a mean age of 60 at the time of diagnosis and a male to female ratio of 6:1. [8][9][10] Although IUPs can occur throughout the urinary tract, approximately 90% of lesions occur in the bladder, most commonly at the bladder neck and trigone. 9,11,12 These lesions are usually small (<5 cm); however, multifocality and larger lesions can occur, which can cause urinary outflow obstruction or ureteral obstruction.…”

Section: Introductionmentioning

confidence: 99%

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Inverted urothelial papilloma: A review of diagnostic pitfalls and clinical management

Sweeney

Rais‐Bahrami

Gordetsky

2017

CUAJ

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Inverted urothelial papilloma (IUP) is a rare, non-invasive endophytic lesion that accounts for 1-2% of urothelial tumours. On cystoscopy, IUP appears as a pedunculated/papillary mass with a smooth surface. On microscopy, IUP has an endophytic growth pattern with the bulk of the tumour covered by a superficial layer of urothelium, which can be hyperplastic or attenuated. The cytology should be bland, with uniform, spindled cells arranged in anastomosing trabeculae and cords with peripheral palisading of basaloid cells. Exophytic papillae and mitotic activity should be absent or focal. Pseudoglandular spaces and squamous metaplasia may also be present. There are distinct molecular differences between IUP and urothelial carcinoma (UC). IUP rarely has mutations of FGFR3, homozygous loss of 9p21, or gain of chromosomes 3, 7, and 17, whereas these mutations are frequently seen in UC. In addition, IUP is much less likely to have TERT mutations compared to UC. Immunohistochemistry can also be helpful in distinguishing the two entities as IUP is typically negative for CK20 and has a low Ki-67 proliferation index. Positivity for p53 may be seen in a minority of IUP. IUP can recur and be seen in association with UC.Distinguishing IUP from UC can be difficult due to the similarity between the two entities both on cystoscopy and histology, as up to 25% of UCs will also have inverted growth. Given the morphologic variants of IUP and UC, it is possible for a diagnostic error to occur, which can significantly impact patient management.

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Section: Imagingmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Inverted urothelial papilloma: A review of diagnostic pitfalls and clinical management

Sweeney

Rais‐Bahrami

Gordetsky

2017

CUAJ

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“…IPB typically appear as narrow basal strips or sphere-like shapes on CT images, with a longitudinal diameter similar to the transverse diameter. Previous research have shown that tipped is a speci c presentation of IPB [14,19,20]. In contrast, the transverse diameter of BUC was signi cantly larger than its longitudinal diameter, indicating that the tumor show more of a broad base and the growth direction spread mainly to the bladder wall on both sides.…”

Section: Discussionmentioning

confidence: 87%

Quantitative differentiation of non-invasive bladder urothelial carcinoma and inverted papilloma based on CT urography

Jin,

Yang,

Liu

et al. 2023

Preprint

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Purpose To investigate the value of CT urography (CTU) indicators in the quantitative differential diagnosis of bladder urothelial carcinoma (BUC) and inverted papilloma of the bladder (IPB). Material and methods Retrospective analysis of clinical and imaging data of 103 patients who underwent CTU prior to transurethral resection of the bladder tumor or radical cystectomy from January 2019 to December 2022. The imaging data included 6 qualitative indicators and 7 quantitative measures. The recorded clinical information and imaging features were subjected to univariate and multivariate logistic regression analysis to find independent risk factors for BUC, and a combined multi-indicator prediction model was constructed, and the prediction model was visualized using nomogram. ROC curve analysis was used to calculate and compare the predictive efficacy of independent risk factors and nomogram. Results Junction smoothness, maximum longitudinal diameter, tumor-wall interface and arterial reinforcement rate were independent risk factors for distinguishing BUC from IPB. The AUC of the combined model was 0.934 (sensitivity = 0.808, specificity = 0.920, accuracy = 0.835), and its diagnostic efficiency was higher than that of junction smoothness (AUC = 0.667, sensitivity = 0.654, specificity = 0.680, accuracy = 0.660), maximum longitudinal diameter (AUC = 0.757, sensitivity = 0.833, specificity = 0.604, accuracy = 0.786), tumor-wall interface (AUC = 0.888, sensitivity = 0.755, specificity = 0.808, accuracy = 0.816) and Arterial reinforcement rate (AUC = 0.786, sensitivity = 0.936, specificity = 0.640, accuracy = 0.864). Conclusion Above qualitative and quantitative indicators based on CTU and the combination of them may be helpful to the differential diagnosis of BUC and IPB, thus better assisting in clinical decision-making.

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“…On MRI, the typical appearance of inverted papilloma of the bladder is a polypoid shape mass with a non-papillary surface and a thin short stalk surrounded by urine. Cystic foci are also occasionally seen within the tumor [ 4 ]. However, diagnosis requires direct visualization and biopsy.…”

Section: Discussionmentioning

confidence: 99%

Benign inverted papilloma at bladder neck causing acute urinary retention

Jones

Kavanagh

2018

Journal of Surgical Case Reports

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Inverted papilloma of the urinary tract is a rare benign lesion. A 59-year-old male who presented with the chief complaint of gross hematuria and acute urinary retention is described. Cystoscopy revealed a solitary, papillary tumor at the bladder neck. Transurethral resection was performed, and histological examination revealed a pathological diagnosis of inverted papilloma. Following resection, the patient was able to void without difficulty. This is an interesting case of acute urinary retention secondary to an inverted papilloma at the bladder neck causing intermittent outlet obstruction, and we review the literature on inverted papilloma of the bladder.

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MRI Findings of Inverted Urothelial Papilloma of the Bladder

Abstract: On MRI, the typical appearance of inverted urothelial papillomas of the bladder is a polypoid shape with a nonpapillary surface and a thin short stalk surrounded by urine. Cystic foci are also occasionally seen within the tumor.

Cited by 10 publications

References 24 publications

Inverted urothelial papilloma: A review of diagnostic pitfalls and clinical management

Inverted urothelial papilloma: A review of diagnostic pitfalls and clinical management

Quantitative differentiation of non-invasive bladder urothelial carcinoma and inverted papilloma based on CT urography

Benign inverted papilloma at bladder neck causing acute urinary retention

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