Pseudocarcinomatous hyperplasia associated with primary lymphoma in the urinary bladder: a case report

Montironi, Rodolfo; Santoni, Matteo; Goteri, Gaia; Mazzucchelli, Roberta; López-Beltrán, Antonio; Liu, Cheng; Scarpelli, Marina

doi:10.1016/j.humpath.2015.03.004

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…Pathological evaluation shows a great variety of morphological alterations in the bladder mucosa as a result of radiation, but similar changes can be seen in other urinary tract passages. The main changes include acute and chronic radiation cystitis with variable mucosal ulceration and denudation and late fibrosis with bladder contracture . Radiation therapy results in cellular and nuclear enlargement with large nuclei, mutinucleation and vacuolization with low nuclear‐to‐cytoplasmic ratio.…”

Section: Radiation Therapymentioning

confidence: 99%

“…Degenerative nuclear features are usually present, but the morphology is recognized normally by the practising pathologist as radiotherapy‐related and degenerative in nature. A reactive, tumour‐like epithelial proliferation with nodules of squamoid epithelium pushing into the lamina propria without evidence of true infiltrative growth, associated with haemorrhage, fibrin deposits, fibrinoid vascular changes and multinucleated stromal cells, is seen frequently at the time of histological evaluation . The late phase of radiation cystitis usually occurs months or years following ionizing radiation.…”

Section: Radiation Therapymentioning

confidence: 99%

“…An important long‐term effect of radiation therapy is de‐novo radiation‐induced urinary tract cancer, commonly urothelial or squamous cell carcinoma. Rare examples of sarcomatoid carcinoma (or carcinosarcoma) or true sarcoma of the urinary bladder have been reported …”

Section: Radiation Therapymentioning

confidence: 99%

“…These tumours are treated frequently by a combination of surgery, immunotherapy, chemotherapy or radiation therapy . The specific therapeutic protocol following internationally validated clinical guides is selected essentially according to pathological features, such as grade and stage, analysed in the clinical context .…”

Section: Introductionmentioning

confidence: 99%

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Iatrogenic changes in the urinary tract

et al. 2016

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A handful of therapeutic procedures are used to treat malignancies of the urinary tract, most frequently intravesical immunotherapy or chemotherapy, but also neoadjuvant systemic chemotherapy. These treatment modalities produce morphological changes in the urothelium that can be mistaken for carcinoma; in particular, these therapies frequently mimic urothelial carcinoma in situ (CIS) urothelial dysplasia or true invasive neoplasia. Drugs such as mitomycin C used after transurethral resection of bladder tumour to reduce recurrences, bacillus Calmette-Guérin (BCG) intravesical immunotherapy to treat high-risk non-muscle-invasive bladder cancer and urothelial CIS and platin-based systemic chemotherapy to improve postcystectomy disease-specific survival are examples of therapy-related atypia seen in the urinary tract. To complicate the pathologist's life, a number of systemic drugs in use to treat other diseases, such cyclophosphamide, used to treat some autoimmune disorders or certain haematological malignancies or, in the case of anaesthetics, ketamine, used increasingly as an illegal recreational drug, may produce similarly relevant atypical changes in the urothelium, and therefore need to be differentiated from intraepithelial neoplasia. Other less frequent procedures, such as photodynamic and laser therapy or the newer gene therapy to treat urothelial neoplasia, remain experimental. An immunohistochemical approach to reactive urothelium versus carcinoma in situ using p53, cytokeratin 20 and CD44 is also valid in the post-therapy setting. The pathologist should be aware of these novelties, as he or she plays a crucial role in evaluating treatment efficacy, but at the same time needs to avoid misdiagnosing secondary atypia as intraepithelial neoplasia.

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Section: Radiation Therapymentioning

confidence: 99%

Section: Radiation Therapymentioning

confidence: 99%

Section: Radiation Therapymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Iatrogenic changes in the urinary tract

et al. 2016

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“…PEH has a known association with cutaneous T‐cell LD, including CD30+ LD and extranodal NK/T cell lymphomas . PEH was also reported in association with extranodal marginal zone lymphoma in the bladder . Similar to the potential diagnostic challenge in the other sites, the complex squamous architecture and association with malignant cells in a bronchial biopsy could easily be misdiagnosed as invasive SCC, a more common cause of pulmonary endobronchial obstructive lesions.…”

Section: Figurementioning

confidence: 99%