Difference between revisions of "Inverted urothelial papilloma"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Inverted_papilloma_high_mag.jpg | |||
| Width = | |||
| Caption = Inverted urothelial papilloma. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = like papillomas... but grow downward; '''never''' have an exophytic component; nests have peripheral palisading of nuclei - '''important''' | |||
| Subtypes = | |||
| LMDDx = [[low grade papillary urothelial carcinoma]] with an inverted growth pattern | |||
| Stains = | |||
| IHC = Ki-67 -ve, CK20 -ve, p53 -ve (rarely +ve) | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[urothelium]] - usu. [[urinary bladder]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = | |||
| Tx = | |||
}} | |||
'''Inverted urothelial papilloma''', also '''inverted papilloma''', is a benign [[urothelium|urothelial]] lesion that may be confused with [[urothelial carcinoma]]. | |||
==General== | |||
*May be confused with papillary urothelial carcinoma with an inverted growth pattern. | |||
==Microscopic== | |||
Features: | |||
*Like papillomas... but grow downward.<ref name=Ref_WMSP310>{{Ref WMSP|310}}</ref> | |||
*According to THvdK,<ref>THvdK. 21 June 2010.</ref> ''inverted papillomas'' '''never''' have an exophytic component; if an exophytic component is present it is urothelial carcinoma. This is disputed by one paper from Mexico that examines two cases.<ref name=pmid19433293>{{cite journal |author=Albores-Saavedra J, Chable-Montero F, Hernández-Rodríguez OX, Montante-Montes de Oca D, Angeles-Angeles A |title=Inverted urothelial papilloma of the urinary bladder with focal papillary pattern: a previously undescribed feature |journal=Ann Diagn Pathol |volume=13 |issue=3 |pages=158–61 |year=2009 |month=June |pmid=19433293 |doi=10.1016/j.anndiagpath.2009.02.009 |url=}}</ref> | |||
*Nests have peripheral palisading of nuclei - '''important'''. | |||
DDx: | |||
*[[Low grade papillary urothelial carcinoma]] with an inverted growth pattern. | |||
*[[Cystitis cystica]]. | |||
===Images=== | |||
====Case 1==== | |||
<gallery> | |||
Image:Inverted_papilloma_high_mag.jpg | Inverted papilloma - high mag. (WC/Nephron) | |||
Image:Inverted_papilloma_intermed_mag.jpg | Inverted papilloma - intermed. mag. (WC/Nephron) | |||
</gallery> | |||
====Case 2==== | |||
<gallery> | |||
Image: Bladder inverted papilloma histopathology (1).jpg | IUP. (WC/KGH) | |||
Image: Bladder inverted papilloma histopathology (2).jpg | IUP. (WC/KGH) | |||
Image: Bladder inverted papilloma histopathology (3).jpg | IUP. (WC/KGH) | |||
</gallery> | |||
==IHC== | |||
May be useful versus inverted growth pattern UCC:<ref name=pmid18043040>{{Cite journal | last1 = Jones | first1 = TD. | last2 = Zhang | first2 = S. | last3 = Lopez-Beltran | first3 = A. | last4 = Eble | first4 = JN. | last5 = Sung | first5 = MT. | last6 = MacLennan | first6 = GT. | last7 = Montironi | first7 = R. | last8 = Tan | first8 = PH. | last9 = Zheng | first9 = S. | title = Urothelial carcinoma with an inverted growth pattern can be distinguished from inverted papilloma by fluorescence in situ hybridization, immunohistochemistry, and morphologic analysis. | journal = Am J Surg Pathol | volume = 31 | issue = 12 | pages = 1861-7 | month = Dec | year = 2007 | doi = 10.1097/PAS.0b013e318060cb9d | PMID = 18043040 }}</ref> | |||
*Ki-67 -ve. | |||
*CK20 -ve. | |||
*p53 -ve (rarely +ve). | |||
==See also== | |||
*[[Urothelium]]. | |||
*[[Urothelial papilloma]]. | |||
*[[Cystitis cystica]]. | |||
==Sign out== | |||
<pre> | |||
Bladder Tumour, Transurthral Resection: | |||
- Inverted papilloma. | |||
</pre> | |||
===Micro=== | |||
The sections show urothelial mucosa with densely packed urothelial nests with peripheral palisading. The cells of the urothelial nests are bland. Proliferative activity is not apparent. Definite papillae are absent. No exophytic component is apparent. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Urothelium]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
Latest revision as of 21:38, 23 June 2025
| Inverted urothelial papilloma | |
|---|---|
| Diagnosis in short | |
 Inverted urothelial papilloma. H&E stain. | |
|
| |
| LM | like papillomas... but grow downward; never have an exophytic component; nests have peripheral palisading of nuclei - important |
| LM DDx | low grade papillary urothelial carcinoma with an inverted growth pattern |
| IHC | Ki-67 -ve, CK20 -ve, p53 -ve (rarely +ve) |
| Site | urothelium - usu. urinary bladder |
|
| |
| Prevalence | uncommon |
| Prognosis | benign |
Inverted urothelial papilloma, also inverted papilloma, is a benign urothelial lesion that may be confused with urothelial carcinoma.
General
- May be confused with papillary urothelial carcinoma with an inverted growth pattern.
Microscopic
Features:
- Like papillomas... but grow downward.[1]
- According to THvdK,[2] inverted papillomas never have an exophytic component; if an exophytic component is present it is urothelial carcinoma. This is disputed by one paper from Mexico that examines two cases.[3]
- Nests have peripheral palisading of nuclei - important.
DDx:
- Low grade papillary urothelial carcinoma with an inverted growth pattern.
- Cystitis cystica.
Images
Case 1
Inverted papilloma - high mag. (WC/Nephron)
Inverted papilloma - intermed. mag. (WC/Nephron)
Case 2
IUP. (WC/KGH)
IUP. (WC/KGH)
IUP. (WC/KGH)
.jpg)
.jpg)
.jpg)
IHC
May be useful versus inverted growth pattern UCC:[4]
- Ki-67 -ve.
- CK20 -ve.
- p53 -ve (rarely +ve).
See also
Sign out
Bladder Tumour, Transurthral Resection:
- Inverted papilloma.
Micro
The sections show urothelial mucosa with densely packed urothelial nests with peripheral palisading. The cells of the urothelial nests are bland. Proliferative activity is not apparent. Definite papillae are absent. No exophytic component is apparent.
References
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 310. ISBN 978-0781765275.
- ↑ THvdK. 21 June 2010.
- ↑ Albores-Saavedra J, Chable-Montero F, Hernández-Rodríguez OX, Montante-Montes de Oca D, Angeles-Angeles A (June 2009). "Inverted urothelial papilloma of the urinary bladder with focal papillary pattern: a previously undescribed feature". Ann Diagn Pathol 13 (3): 158–61. doi:10.1016/j.anndiagpath.2009.02.009. PMID 19433293.
- ↑ Jones, TD.; Zhang, S.; Lopez-Beltran, A.; Eble, JN.; Sung, MT.; MacLennan, GT.; Montironi, R.; Tan, PH. et al. (Dec 2007). "Urothelial carcinoma with an inverted growth pattern can be distinguished from inverted papilloma by fluorescence in situ hybridization, immunohistochemistry, and morphologic analysis.". Am J Surg Pathol 31 (12): 1861-7. doi:10.1097/PAS.0b013e318060cb9d. PMID 18043040.