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Lee KH, Kim NI, Nam JH, Kim SS. Gastric-type adenocarcinoma of the uterine cervix presenting in urine cytology specimens: A case report and literature review. Diagn Cytopathol 2024; 52:E80-E83. [PMID: 38140795 DOI: 10.1002/dc.25268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/04/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
Gastric-type endocervical adenocarcinoma (GEA) is a rare type adenocarcinoma of the uterine cervix that is unrelated to human papillomavirus (HPV). GEA is difficult to diagnose due to its bland-looking morphological characteristics and is therefore often underdiagnosed. Although abnormal cells may be seen on cervical cytology specimens, they are rarely diagnosed as malignant and are often classified as atypical glandular cells. As a result, GEA may be diagnosed at advanced stages, with cytology samples from other organs after it has already invaded adjacent organs. Here, we report a case of GEA diagnosed by both cytological and histological examinations of urinary bladder and uterine cervix, after being identified as a non-urothelial malignancy on a urine cytology. We also review and summarize the differential diagnoses for non-urothelial lesions, particularly for glandular lesions observed on urinary cytology specimens, as well as the cytological and histological characteristics of GEA.
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Affiliation(s)
- Kyung-Hwa Lee
- Department of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea
- Department of Pathology, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea
| | - Nah Ihm Kim
- Department of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea
- Department of Pathology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jong-Hee Nam
- Department of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea
- Department of Pathology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Sung Sun Kim
- Department of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea
- Department of Pathology, Chonnam National University Hospital, Gwangju, Republic of Korea
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2
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Intraoperative Appearance of Endosalpingiosis: A Single-Center Experience of Laparoscopic Findings and Systematic Review of Literature. J Clin Med 2022; 11:jcm11237006. [PMID: 36498581 PMCID: PMC9738105 DOI: 10.3390/jcm11237006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Endosalpingiosis is assumed to be the second most common benign peritoneal pathology after endometriosis in women. Although recent studies indicate a significant association with gynecologic malignancies, many underlying principles remain unclear. This work aimed to systematically describe the intraoperative appearance of endosalpingiosis. Methods: Data and intraoperative videos of patients with histologically verified endosalpingiosis were retrospectively reviewed. The main outcome measures were macroscopic phenotype and anatomical distribution. Additionally, a systematic review searching PubMed (Medline) and Embase was conducted. Results: In the study population (n = 77, mean age 40.2 years (SD 16.4)), the mean size of lesions was 3.6 mm and the main visual pattern was vesicular (62%). The most frequent localization was the sacrouterine ligaments (24.7%). In the systematic review population (n = 1174 (210 included studies overall), mean age 45.7 years (SD 14.4)), there were 99 patients in 90 different studies with adequate data to assess the appearance of the lesions. The mean size of the lesions was 48.5 mm, mainly with a cystic visual pattern (49.5%). The majority of the lesions affected the ovaries (23.2%), fallopian tubes (20.4%), or lymph nodes (18.5%). Comparing this study to the literature population, the main differences concerned the size (p < 0.001) and main visual patterns (p < 0.001) of lesions. Conclusions: The usual intraoperative findings of endosalpingiosis appeared less impressive than described in the literature. In our study population, lesions of a few millimeters in size with a vesicular appearance were mostly seen, most frequently in the sacrouterine ligament area. Intraoperative recognition by the gynecologic surgeon and histologic diagnosis should play an important role in further understanding this entity, scientifically and clinically.
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3
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Sancheti S, Somal PK, Chaudhary D, Khandelwal S. Mullerianosis of urinary bladder: The great impersonator. INDIAN J PATHOL MICR 2021; 63:627-629. [PMID: 33154321 DOI: 10.4103/ijpm.ijpm_726_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Müllerianosis of the urinary bladder is a rare entity with less than 30 cases reported. It encompasses a mixture of different types of Mullerian lesions like endometriosis, endocervicosis, and endosalpingiosis. It typically affects the women of reproductive age group. The symptoms vary from hematuria and dysuria, to pelvic pain, which may be associated with menstruation. It can mimic a malignant tumor clinically and radiologically; hence, it is important that a correct diagnosis is rendered in these cases to avoid unnecessary radical procedures. Herein we report a case of mullerianosis of the urinary bladder in a young female and discuss the important differential diagnosis and various treatment modalities.
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Affiliation(s)
- Sankalp Sancheti
- Department of Pathology, Homi Bhabha Cancer Hospital, Sangrur, Punjab, India
| | - Puneet Kaur Somal
- Department of Pathology, Homi Bhabha Cancer Hospital, Sangrur, Punjab, India
| | - Debashish Chaudhary
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital, Sangrur, Punjab, India
| | - Sachin Khandelwal
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital, Sangrur, Punjab, India
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Fakhralddin SS, Mahmood SN, Qader DK, Ali AA, Kakamad FH, Salih AM, Abdullah HO. Mullerianosis of the urinary bladder; A case report. Int J Surg Case Rep 2021; 83:106040. [PMID: 34102604 PMCID: PMC8187240 DOI: 10.1016/j.ijscr.2021.106040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/16/2021] [Accepted: 05/21/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Mullerianosis is a sporadic condition of the urinary bladder. The study aims to present a case of mullerianosis with a brief literature review. CASE PRESENTATION A 52-year-old lady presented with hematuria for one-year duration. A general urine examination showed microscopic hematuria. Abdominal and transvaginal ultrasonography revealed a soft tissue mass (13 * 10 mm) within the base of the urinary bladder. Cystoscopy showed 1.0 * 1.3 cm benign-looking mass bulging into the posterior bladder wall covered by a normal bladder mucosa. Transurethral resection was done. The histopathological examination was consistent with mullerianosis. DISCUSSION Two hypotheses have been proposed; the first one (implantation theory) believing that at the time of pelvic surgery and caesarian delivery Mullerian tissues become implanted inside the bladder. The second theory (metaplastic theory) holds the probability of differentiation of Mullerian epithelium to endometrial, endocervical, and tubal components and proliferation in the bladder. CONCLUSION mullerianosis is a very infrequent entity that mainly affects the urinary bladder and is mainly reported in females during the reproductive period, medical and surgical treatment are both regarded as the management options.
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Affiliation(s)
- Saman Salih Fakhralddin
- Sulaymaniyah General Teaching Hospital, Urology Department, Sulaymaniyah, Iraq; Smart Health Tower, Madam Mitterrand Str, Sulaimani, Kurdistan, Iraq
| | - Sarwar Noori Mahmood
- Department of Surgery, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Iraq
| | - Deedar Kamaran Qader
- Sulaymaniyah General Teaching Hospital, Urology Department, Sulaymaniyah, Iraq; Smart Health Tower, Madam Mitterrand Str, Sulaimani, Kurdistan, Iraq
| | - Alaa Abbas Ali
- Department of Pathology, University of Sulaimani College of Medicine, Sulaimani, Iraq
| | - Fahmi H Kakamad
- Smart Health Tower, Madam Mitterrand Str, Sulaimani, Kurdistan, Iraq; College of Medicine, University of Sulaimani, Sulaimani, Kurdistan, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq.
| | - Abdulwahid M Salih
- Smart Health Tower, Madam Mitterrand Str, Sulaimani, Kurdistan, Iraq; College of Medicine, University of Sulaimani, Sulaimani, Kurdistan, Iraq
| | - Hiwa O Abdullah
- Smart Health Tower, Madam Mitterrand Str, Sulaimani, Kurdistan, Iraq; Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
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5
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Ghosh S, Onol F, Vasquez J, Parikh J. Müllerianosis of the Urinary Bladder: A Rare Condition Which Mimics Neoplasia. Cureus 2021; 13:e15147. [PMID: 34178484 PMCID: PMC8216577 DOI: 10.7759/cureus.15147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2021] [Indexed: 11/05/2022] Open
Abstract
Müllerianosis of the urinary bladder is an extremely rare, benign condition defined by the presence of at least two of the three müllerian-derived components (endosalpinx, endometrium, and endocervix) in the lamina propria and muscularis propria of the urinary bladder. It frequently mimics neoplastic condition, either malignant or benign. Here, we present a case of cystic müllerianosis of urinary bladder, which was clinically thought to be a urinary bladder neoplasm.
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Affiliation(s)
- Somshukla Ghosh
- Internal Medicine, University of Central Florida-HCA Healthcare Graduate Medical Education, Greater Orlando, USA
| | - Fikret Onol
- Urology, Orlando Veterans Affairs Medical Center, Orlando, USA
| | - Jonathan Vasquez
- Pathology, Orlando Veterans Affairs Medical Center, Orlando, USA
| | - Jignesh Parikh
- Pathology, Orlando Veterans Affairs Medical Center, Orlando, USA
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Bocchialini T, Ziglioli F, Palmieri G, Barbieri A, Infranco A, Milandri R, Simonetti E, Ferretti S, Maestroni U. Müllerianosis of the urinary bladder may simulate a bladder cancer: a case report. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021148. [PMID: 33944832 PMCID: PMC8142764 DOI: 10.23750/abm.v92is1.9825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 11/23/2022]
Abstract
Müllerianosis is an extremely rare entity consisting of an admixture of 2 or more müllerian tissues. We report the case of a 61 years old woman who came to our attention with hypogastric pain and dysuria. She was in menopause and had a previous history of cesarean section. Ultrasound and CT-scan of the abdomen showed a proliferative bladder lesion close to the left ureteric orifice. Transurethral resection of the bladder (TUR-B) was performed. Histopathological examination of the specimens was negative for bladder cancer and revealed the presence of endosalpingeal tissue. Postoperative course was unremarkable as well as follow up at 12 months. A proper knowledge and awareness of this disease, even if rare, is necessary for an accurate differential diagnosis and to perform an appropriate treatment. (www.actabiomedica.it)
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Affiliation(s)
| | | | - Gerardo Palmieri
- Department of General Surgery, University-Hospital of Parma, Italy.
| | | | - Antonia Infranco
- Department of Obstetrics and Gynaecolgy, University-Hospital of Parma, Italy.
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7
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Rajaian S, Murugasen L, Jain D, Chakravarthy Narasimhachar S. Müllerianosis of the urinary bladder with unilateral complete renal agenesis: a rare coincidental finding causing delayed presentation. BMJ Case Rep 2020; 13:13/7/e235217. [PMID: 32675120 DOI: 10.1136/bcr-2020-235217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Müllerianosis is a rare benign lesion of the urinary bladder, which is constituted by two or more of the Müllerian-duct-derived tissues. We report a 45-year-old perimenopausal multiparous woman presenting with occasional episodes of dysuria and lower abdominal discomfort of recent duration. Ultrasound examination revealed a well-defined lesion in urinary bladder and the absence of left kidney. Contrast-enhanced CT of the abdomen confirmed the findings. During diagnostic cystoscopy, haemorrhagic polypoidal lesions were noted in the left side of the posterolateral wall and dome of urinary bladder along with the absence of left ureteric orifice. Transurethral resection of the bladder lesions was done and histology examination confirmed the diagnosis of Müllerianosis. She was administered Luteinizing hormone-releasing hormone (LHRH) agonist monthly. At 1 year of follow-up, cystoscopy showed only scar tissue. The case was reported for the rarity of Müllerianosis noted in a patient with unilateral agenesis of kidney, a possible cause of delayed presentation.
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Affiliation(s)
| | | | - Deepti Jain
- Department of Pathology, MIOT International, Chennai, India
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8
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Jhang S, Chen M, Chen LC. Concurrent müllerianosis of the urinary bladder and the umbilicus presenting with umbilical bleeding: a rare case report and review of the literature. BMC WOMENS HEALTH 2020; 20:66. [PMID: 32245454 PMCID: PMC7119285 DOI: 10.1186/s12905-020-00929-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 03/18/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Müllerianosis is a very rare neoplasm composed of two or three Müllerian derived tissues (endosalpinx, endometrium and endocervix). We report the first case of concurrent müllerianosis of the urinary bladder and the umbilicus presenting with umbilical bleeding. CASE PRESENTATION A 43-year-old Asian premesopausal female, gravida 1, para 1, presented with intermittent umbilical bleeding. An umbilical nodule and a bladder tumor on the posterior wall of the urinary bladder were identified. She underwent transurethral resection of the bladder tumor and excision of the umbilical nodule successively. Diagnosis of müllerianosis was confirmed by the histological and immunological features. No tumor recurrence was noted at 6 months of follow-up. CONCLUSIONS Müllerianosis is extremely rare and mainly reported in the urinary bladder, and generally affects women of reproductive age. Despite the common presentations of müllerianosis of the urinary bladder including irritative voiding symptoms, abdominal/pelvic pain and gross hematuria, our rare case had no symptom except umbilical bleeding. The possibility of concurrent bladder müllerianosis should be considered when müllerianosis is found at other location. We suggest a surgical intervention to establish the correct pathological diagnosis because it is essential to exclude malignant neoplasms of the urinary bladder. The majority of patients have a favorable prognosis.
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Affiliation(s)
- Syu Jhang
- Department of Urology, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei, 10449, Taiwan.,School of Medicine, Mackay Medical College, Sanzhi, Taiwan.,Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Marcelo Chen
- Department of Urology, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei, 10449, Taiwan.,School of Medicine, Mackay Medical College, Sanzhi, Taiwan.,Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Li-Chen Chen
- Department of Urology, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei, 10449, Taiwan. .,School of Medicine, Mackay Medical College, Sanzhi, Taiwan. .,Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.
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9
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Habiba M, Brosens I, Benagiano G. Müllerianosis, Endocervicosis, and Endosalpingiosis of the Urinary Tract: A Literature Review. Reprod Sci 2018; 25:1607-1618. [PMID: 29739266 DOI: 10.1177/1933719118773441] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION AND HYPOTHESIS We reviewed reported cases of endocervicosis, endosalpingiosis, and müllerianosis of the bladder or ureters in women in order to highlight these conditions as distinct from endometriosis or adenomyosis. METHODS Medline and Scopus searches of all cases published till the October 1, 2017. All retrieved references were searched manually to identify relevant articles. RESULTS Twenty-six articles reported endocervicosis. These included 37 cases described by the authors as endocervicosis of the bladder. We identified 7 case reports of bladder endosalpingiosis. There were 26 publications including 27 cases of müllerianosis of the bladder and 3 cases affecting the lower ureter. Literature descriptions are limited but available accounts do not point to features that uniquely distinguished these conditions. Affected women tended to be older, and in many cases, there was a possible relation to past surgery and particularly to hysterectomy and caesarean sections. Many cases were reported in postmenopausal women. Local excision was sufficient in most cases. CONCLUSION The etiology of these conditions remains speculative, but case reports raise a possible link to pelvic surgery. There is a need for more detailed accounts of these lesions, which should be considered in the differential diagnosis of pre- and postmenopausal women with pelvic pain, dyspareunia, lower abdominal pain or discomfort, dysuria, frequency, or hematuria.
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Affiliation(s)
- Marwan Habiba
- 1 Department of Health Sciences, University of Leicester, Women and Perinatal Services, University Hospitals of Leicester, Leicester, United Kingdom
| | - Ivo Brosens
- 2 Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Giuseppe Benagiano
- 3 Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy
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10
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Amir RAR, Taheini KM, Sheikh SS. Mullerianosis of the Urinary Bladder: A Case Report. Case Rep Oncol 2018; 11:206-211. [PMID: 29681822 PMCID: PMC5903129 DOI: 10.1159/000487429] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 02/04/2018] [Indexed: 11/19/2022] Open
Abstract
Mullerianosis is a rare entity consisting of an admixture of 2 or more of the following tissues: endometriosis, endocervicosis, and endosalpingiosis. It most commonly affects the urinary bladder and affects females of fertile age. It presents clinically as hematuria, dysuria, and pelvic pain which may be associated with menstruation. Radiologically and macroscopically, it typically presents as a polypoid mass in the dome or posterior wall of the bladder. Histologically, it consists of glands of varying size lined by endometrial, endocervical, or tubal epithelium. Mullerianosis clinically and histologically mimics other benign and malignant lesions. Herein we report a case of mullerianosis of the urinary bladder. This is a rare lesion with less than 20 cases reported in the literature thus far. We believe raising awareness of this poorly recognized entity is of utmost significance in order to avoid misdiagnosis and the following unnecessary radical procedures.
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Affiliation(s)
| | - Khalid M Taheini
- Consultant Urologist, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Salwa S Sheikh
- Pathology Services Division, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
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11
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Patel A, Desai P, Malczewski F, Stephens D. Müllerianosis of the urinary bladder: a rare and problematic bladder tumour. BMJ Case Rep 2017; 2017:bcr-2016-218772. [PMID: 28275021 DOI: 10.1136/bcr-2016-218772] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Müllerianosis of the bladder is an extremely rare and highly symptomatic bladder tumour comprising of at least two types of Müllerian derived tissues. We present the case of a 59-year-old woman presenting with painful macroscopic haematuria associated with urgency, frequency and incontinence. She is a nulliparous postmenopausal woman without malignancy risk factors or previous abdominal surgery. Initially identified on ultrasound scan, she was taken for transurethral resection of bladder tumour (TURBT). Histology confirms the diagnosis. Repeat TURBT was required for non-resolution of symptoms. Despite a thorough resection, symptoms recurred within months necessitating partial cystectomy. Although a 'benign' lesion, this lesion proved a difficult condition to treat requiring partial cystectomy.
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Affiliation(s)
- Amit Patel
- Department of Urology, Queen Elizabeth II Jubilee Hospital, Acacia Ridge, Queensland, Australia.,Griffith University, Gold Coast, Australia
| | - Pranali Desai
- Department of Gynaecology, Queen Elizabeth II Jubilee Hospital, Acacia Ridge, Queensland, Australia
| | - Frances Malczewski
- Department of Pathology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Daryl Stephens
- Department of Urology, Mackay Base Hospital, Mackay, Queensland, Australia
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12
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Ishikawa R, Kadota K, Hayashi T, Motoyama M, Matsunaga T, Miyai Y, Katsuki N, Kushida Y, Haba R. Cytopathological features of villous adenoma of the urinary bladder in urine: A rare case report. Diagn Cytopathol 2016; 44:632-5. [PMID: 27121034 DOI: 10.1002/dc.23488] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/26/2016] [Accepted: 03/30/2016] [Indexed: 01/23/2023]
Abstract
Villous adenoma of the urinary bladder is a rare tumor that histologically mimics its enteric counterpart. Patients with an isolated villous adenoma have an excellent prognosis, but associated adenocarcinomas can frequently be identified in them as well. There is no literature that discusses the cytopathologic features of villous adenoma. Here we report a case which was diagnosed as villous adenoma histologically, which has been followed up with urine cytology. In urine cytology, many mucin producing cells are recognized. Few cell clusters show glandular formation or arrangement along the basement membrane. When glandular cells with columnar mucin-filled goblet cells are seen in urine cytology, the presence of a primary glandular lesion of the urinary bladder, such as villous adenoma, should be considered possible. Diagn. Cytopathol. 2016;44:632-635. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ryou Ishikawa
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Kyuichi Kadota
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Toshitetsu Hayashi
- Department of Diagnostic Pathology, Takamatsu Red Cross Hospital, Kagawa, Japan
| | - Mutsumi Motoyama
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Toru Matsunaga
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yumi Miyai
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Naomi Katsuki
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yoshio Kushida
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Reiji Haba
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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13
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Chaump M, Giorgadze T, Schreiner AM. Urine cytology: Pitfall due to a "remnant" lesion. Cytojournal 2015; 12:16. [PMID: 26288651 PMCID: PMC4527229 DOI: 10.4103/1742-6413.161604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 06/07/2015] [Indexed: 11/04/2022] Open
Affiliation(s)
- Michael Chaump
- Address: 525 East 68 Street, Room F-766, New York Presbyterian Hospital, Weill Cornell Medical Center, Papanicolaou Cytology Laboratory, New York, NY 10065, USA
| | - Tamar Giorgadze
- Address: 525 East 68 Street, Room F-766, New York Presbyterian Hospital, Weill Cornell Medical Center, Papanicolaou Cytology Laboratory, New York, NY 10065, USA
| | - Andrew M Schreiner
- Department of Pathology, New York Hospital Queens, Flushing, NY 11355, USA
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14
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Branca G, Barresi V. Müllerianosis of the Urinary Bladder: A Rare Tumorlike Lesion. Arch Pathol Lab Med 2014; 138:432-6. [DOI: 10.5858/arpa.2012-0681-rs] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Müllerianosis was first described as a rare entity consisting of an admixture of cervical, tubaric, or endometrial epithelium within the lamina propria and muscularis propria of the urinary bladder. This lesion occurs mainly in the dome or posterior wall of the urinary bladder in women of fertile age. Its clinical presentation is characterized by hematuria, pelvic pain, and dysuria, nonspecific symptoms that are related to the responsiveness of müllerian glands to hormonal stimuli. The major interest of müllerianosis resides in its similarity, from clinical, cytologic, and histologic viewpoints, to more threatening conditions, such as neoplasias. The clinical context and the identification of periglandular endometrial stroma at histologic examination with conventional hematoxylin-eosin stain, as well as the immunohistochemical demonstration of estrogen and progesterone receptors in the glands, are of diagnostic utility in the differential diagnosis. Müllerianosis may be responsive to gonadotropin-releasing hormone agonists. Surgical resection may be justified in the case of clinical symptoms refractory to hormone therapy.
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Affiliation(s)
- Giovanni Branca
- From the Department of Pathology, University of Messina, Messina, Italy
| | - Valeria Barresi
- From the Department of Pathology, University of Messina, Messina, Italy
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15
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Rajakumar C, Vilos GA, Vilos AG, Marks JL, Ettler HC, Pautler SS. Combined Transurethral and Laparoscopic Partial Cystectomy and Robotically Assisted Bladder Repair for the Treatment of Bladder Endocervicosis: Case Report and Review of the Literature. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2014; 36:141-145. [DOI: 10.1016/s1701-2163(15)30660-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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17
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18
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McSorley S, Kochman A, DeSouza J. Grand rounds: müllerianosis of the urinary bladder in a postmenopausal woman. Urology 2013; 81:488-90. [PMID: 23312895 DOI: 10.1016/j.urology.2012.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 11/03/2012] [Accepted: 11/09/2012] [Indexed: 10/27/2022]
Affiliation(s)
- Stephen McSorley
- Department of Urology, Monklands District General Hospital, Airdrie, United Kingdom.
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19
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Ndokera R, Brewster S, Dhar S. Mullerianosis: a rare cause of acute renal colic. BMJ Case Rep 2012; 2012:bcr-2012-006704. [PMID: 23097575 DOI: 10.1136/bcr-2012-006704] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 50-year-old woman presented to the urology department with an acute history suggestive of left-sided renal colic. There were no other associated symptoms, but urine dipstick revealed non-visible haematuria. CT-KUB revealed a soft tissue mass at the left vesico-ureteric junction. Flexible cystoscopy demonstrated a mass intruding into the posterior bladder. A transurethral resection of the bladder 'tumour' was undertaken, and it was noted that the mass was not macroscopically consistent with transitional cell carcinoma. Histology demonstrated Müllerianosis, a rare lesion characterised by locally invasive growth of tissue originating from the Müllerian (paramesonephric) duct. The patient was seen by gynaecologist who initiated hormone treatment with an lutenising hormone--releasing hormone (LH-RH) analogue. Urological follow-up 3 months later highlighted ongoing pelvic pain but no further colicky loin pain. Repeat cystoscopy showed the mass had become smaller and the left ureter was laterally displaced. Further gynaecological input is planned if symptoms are ongoing.
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Cheah PL, Looi LM, Lee GEG, Teoh KH, Mun KS, Nazarina AR. Unusual finding of endocervical-like mucinous epithelium in continuity with urothelium in endocervicosis of the urinary bladder. Diagn Pathol 2011; 6:56. [PMID: 21699710 PMCID: PMC3130636 DOI: 10.1186/1746-1596-6-56] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 06/23/2011] [Indexed: 11/10/2022] Open
Abstract
Endocervicosis in the urinary bladder is a rare benign condition. We present a case in a 37-year-old woman with classical clinical and pathological features of endocervicosis. The unusual observation of endocervical-like mucinous epithelium in continuity with the urothelium in addition to fully developed endocervicosis prompted immunohistochemical profiling of the case using antibodies to cytokeratins (AE1/AE3, CK19, CK7, CK5/6, CK20), HBME-1, estrogen receptor (ER) and progesterone receptor (PR) to assess the relationship of the surface mucinous and endocervicosis glandular epithelia. The surface mucinous epithelium, urothelium and endocervicosis glands were immunopositive for AE1/AE3, CK7 and CK19 while CK20 was only expressed by few urothelial umbrella cells. The surface mucinous epithelium was CK5/6 and HBME-1 immunonegative but showed presence of ER and PR. This was in contrast to the urothelium's expression of CK5/6 but not ER and PR. In comparison, endocervicosis glands expressed HBME-1, unlike the surface mucinous epithelium. The endocervicosis epithelium also demonstrated the expected presence of ER and PR and CK5/6 immunonegativity. The slightly differing immunohistochemical phenotypes of the surface mucinous and morphologically similar endocervicosis glandular epithelium is interesting and requires further clarification to its actual nature. The patient has remained well and without evidence of disease 18-months following transurethral resection of the lesion.
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Affiliation(s)
- Phaik-Leng Cheah
- Department of Pathology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
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