Bladder Flashcards
Bladder lesion with sheets of histiocytes with granular eosinophilic cytoplasm (von Hansemann cells), containing round basophilic cytoplasmic inclusions (Michaelis-Gutmann bodies) that look like archery targets.
Malakoplakia
Plan:
Correlate with clinical history and radiology (?immunosupression ?history of urinary infection)
Special stains: Von Kossa (to highlight Michaelis-Guttman bodies)
Endophytic growth of normal thickness urothelium (≤ 7 cells) forming anastomosing cords, islands and trabeculae. Cells are bland with preserved polarity.
Inverted urothelial papilloma
Differential diagnosis:
Florid von Brunn nest proliferation
Carcinoid tumour
Plan:
Correlate with clinical history and cystoscopic impression
IPX to support Dx: Not required
IPX to discount DDx: Synaptophysin, chromogranin
No specific further action required for this benign diagnosis.
Bladder lesion with multiple small tubules in superficial lamina propria lined by cuboidal to columnar (sometimes ‘hobnail’) cells. Tubules surrounded by a thickened hyalinized basement membrane. Can also show polypoid / papillary growth. Lacks desmoplastic stromal response, necrosis, or mitosis
Nephrogenic metaplasia / adenoma
Differential diagnosis:
Clear cell adenocarcinoma
Rule out urothelial carcinoma and prostatic adenocarcinoma
Plan:
Correlate with clinical history and cystoscopic impression (?history of bladder instrumentation or infection ?renal transplant)
IPX to support Dx: AE1/AE3, PAX8 (expect positive)
IPX to discount DDx: CAIX, GATA3, NKX3.1
No specific further action required for this benign diagnosis
