Difference between revisions of "Keratinising squamous metaplasia of the urinary bladder"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Keratinizing squamous metaplasia of the bladder -- low mag.jpg
| Width      =
| Caption    = Keratinizing squamous metaplasia of the bladder. [[H&E stain]]. (WC/Nephron)
| Synonyms  =
| Micro      = squamous epithelium with hyperkeratosis or parakeratosis, negative for atypia
| Subtypes  =
| LMDDx      = [[squamous dysplasia]] of the metaplastic epithelium, [[squamous cell carcinoma of the urinary bladder]], metastatic [[squamous cell carcinoma]], [[urothelial carcinoma]] with squamous metaplasia or squamous differentiation
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Staging    =
| Site      = [[urinary bladder]]
| Assdx      =
| Syndromes  =
| Clinicalhx = usually males (males:females = 4:1)
| Signs      =
| Symptoms  =
| Prevalence = rare
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign, increased risk of malignancy
| Other      =
| ClinDDx    =
| Tx        = clinical follow-up
}}
'''Keratinising squamous metaplasia of the urinary bladder''' is a rare benign change of the [[urinary bladder]] associated with an increased risk of [[malignancy]];<ref name=pmid12429156>{{Cite journal  | last1 = Khan | first1 = MS. | last2 = Thornhill | first2 = JA. | last3 = Gaffney | first3 = E. | last4 = Loftus | first4 = B. | last5 = Butler | first5 = MR. | title = Keratinising squamous metaplasia of the bladder: natural history and rationalization of management based on review of 54 years experience. | journal = Eur Urol | volume = 42 | issue = 5 | pages = 469-74 | month = Nov | year = 2002 | doi =  | PMID = 12429156 }}</ref> however, it is not considered a pre-malignant condition.<ref name=pmid1379440>{{Cite journal  | last1 = Kvist | first1 = E. | last2 = Sjølin | first2 = KE. | last3 = Laursen | first3 = H. | last4 = Orntoft | first4 = TF. | last5 = Sturmer | first5 = MA. | title = Squamous cell metaplasia of the bladder urothelium. A retrospective study of 36 patients. | journal = APMIS | volume = 100 | issue = 7 | pages = 650-4 | month = Jul | year = 1992 | doi =  | PMID = 1379440 }}</ref><ref name=pmid18931537>{{Cite journal  | last1 = Ahmad | first1 = I. | last2 = Barnetson | first2 = RJ. | last3 = Krishna | first3 = NS. | title = Keratinizing squamous metaplasia of the bladder: a review. | journal = Urol Int | volume = 81 | issue = 3 | pages = 247-51 | month =  | year = 2008 | doi = 10.1159/000151398 | PMID = 18931537 }}</ref>
'''Keratinising squamous metaplasia of the urinary bladder''' is a rare benign change of the [[urinary bladder]] associated with an increased risk of [[malignancy]];<ref name=pmid12429156>{{Cite journal  | last1 = Khan | first1 = MS. | last2 = Thornhill | first2 = JA. | last3 = Gaffney | first3 = E. | last4 = Loftus | first4 = B. | last5 = Butler | first5 = MR. | title = Keratinising squamous metaplasia of the bladder: natural history and rationalization of management based on review of 54 years experience. | journal = Eur Urol | volume = 42 | issue = 5 | pages = 469-74 | month = Nov | year = 2002 | doi =  | PMID = 12429156 }}</ref> however, it is not considered a pre-malignant condition.<ref name=pmid1379440>{{Cite journal  | last1 = Kvist | first1 = E. | last2 = Sjølin | first2 = KE. | last3 = Laursen | first3 = H. | last4 = Orntoft | first4 = TF. | last5 = Sturmer | first5 = MA. | title = Squamous cell metaplasia of the bladder urothelium. A retrospective study of 36 patients. | journal = APMIS | volume = 100 | issue = 7 | pages = 650-4 | month = Jul | year = 1992 | doi =  | PMID = 1379440 }}</ref><ref name=pmid18931537>{{Cite journal  | last1 = Ahmad | first1 = I. | last2 = Barnetson | first2 = RJ. | last3 = Krishna | first3 = NS. | title = Keratinizing squamous metaplasia of the bladder: a review. | journal = Urol Int | volume = 81 | issue = 3 | pages = 247-51 | month =  | year = 2008 | doi = 10.1159/000151398 | PMID = 18931537 }}</ref>
''Urinary bladder with squamous metaplasia'' and ''squamous metaplasia of the urinary bladder'' redirect to this article.


==General==
==General==
*Non-keratinizing squamous metaplasia can be considered normal and is relatively common in trigone region of the bladder in women.
*Rare.<ref name=pmid18931537/> ‡
*Large age range (13-80 years).<ref name=pmid12429156/>
*Large age range (13-80 years).<ref name=pmid12429156/>
*Predominantly males - almost 4:1 (27 males:7 females in one series<ref name=pmid12429156/>).
*Predominantly males - almost 4:1 (27 males:7 females in one series<ref name=pmid12429156/>).


Treatment:
Treatment:
*Follow-up is recommended.<ref name=pmid18931537/>
*Follow-up is recommended.<ref name=pmid18931537/><ref>{{cite journal |authors=Benelli A, Varca V, Vaccaro C, Guzzo S, Nicola M, Onorati M, Gregori A, Di Nuovo F |title=Keratinizing squamous metaplasia of the bladder: Our experience and current approaches |journal=Urologia |volume=87 |issue=2 |pages=97–100 |date=May 2020 |pmid=30509153 |doi=10.1177/0391560318810197 |url=}}</ref>
 
Note:
*‡ Non-keratinizing squamous metaplasia can be considered normal and is relatively common in the trigone region of the bladder in women.{{fact}}


==Microscopic==
==Microscopic==
Features:
Features:
*Squamous epithelium with hyperkeratosis or parakeratosis.
*Squamous epithelium with hyperkeratosis or parakeratosis.
*Negative for significant [[nuclear atypia]].


DDx:
DDx:
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*[[Squamous cell carcinoma of the urinary bladder]].
*[[Squamous cell carcinoma of the urinary bladder]].
*Metastatic [[squamous cell carcinoma]], e.g. [[squamous cell carcinoma of the uterine cervix]].
*Metastatic [[squamous cell carcinoma]], e.g. [[squamous cell carcinoma of the uterine cervix]].
*[[Urothelial carcinoma]] with squamous metaplasia or squamous differentiation.
==Sign out==
<pre>
Urinary Bladder Lesion, Biopsy:
- Extensive keratinizing squamous metaplasia with degenerative changes and acute
  and chronic inflammation.
- NEGATIVE for dysplasia and NEGATIVE for malignancy.
Comment:
Regular follow-up is recommended.[1,2]
1. Urol Int 81 (3): 247-51. doi:10.1159/000151398. PMID 18931537.
2. Urologia 87 (2): 97–100. doi:10.1177/0391560318810197. PMID 30509153.
</pre>


==See also==
==See also==
*[[Squamous cell carcinoma of the urinary bladder]].
*[[Squamous cell carcinoma of the urinary bladder]].
*[[Squamous metaplasia]].


==References==
==References==
48,470

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