Inverted urothelial papilloma: Difference between revisions
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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]] | ||