Carcinoma arising in urinary bladder diverticula: imaging findings in six patients

OBJECTIVE

Carcinoma arising within urinary bladder diverticula has a poorer prognosis than do neoplasms that originate within the main bladder lumen as a result of early transmural tumor infiltration. Imaging plays an important role in diagnosing and staging the disease. We describe the radiologic findings in six patients with pathologically proved diverticular carcinomas.

MATERIALS AND METHODS

We reviewed the records of six patients who had radiologic examinations and surgically confirmed vesical diverticular carcinomas. The examinations included excretory urography in three patients, cystography in three patients, CT in five patients, and MR imaging in one patient. All patients had hematuria. Five patients had transitional cell carcinoma, and one patient had squamous cell carcinoma.

RESULTS

Three of the tumors manifested as an intraluminal filling defect within a bladder diverticulum on excretory urograms or cystograms. In one patient, CT scans showed a concentric soft-tissue tumor in a diverticular neck. Correlative cystograms showed only smooth narrowing in this area. CT and MR imaging showed a tumor within a large diverticulum, which was not visualized on cystograms because of obstruction at the diverticular orifice.

CONCLUSION

Imaging plays an important role in identifying bladder diverticula as a potential site of occult neoplasm.

Disappearing breast calcifications: mammographic-pathologic discrepancy due to calcium oxalate

We have reported a case in which breast biopsy was done to study suggestive microcalcifications that were confirmed by specimen radiography but were not evident with standard light microscopy. Examination of the specimen under polarized light revealed calcium oxalate crystals. Awareness of this potential pitfall should minimize the number of radiologic-pathologic discrepancies.

Diffuse lung uptake of technetium-99m sulfur colloid associated with fatty liver disease of pregnancy

Diffuse pulmonary uptake of sulfur colloid was seen in a 35-year-old postpartum white female with the presumptive diagnosis of fatty liver disease of pregnancy. As the disease process resolved, the pulmonary uptake of sulfur colloid disappeared. To the authors' knowledge, this scan association has not been previously reported.