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

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'''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>
{{ 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>
 
''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:
*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:
*[[Squamous dysplasia]] of the metaplastic epithelium.
*[[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==

Latest revision as of 13:58, 25 May 2023

Keratinising squamous metaplasia of the urinary bladder
Diagnosis in short

Keratinizing squamous metaplasia of the bladder. H&E stain. (WC/Nephron)

LM squamous epithelium with hyperkeratosis or parakeratosis, negative for atypia
LM DDx 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
Site urinary bladder

Clinical history usually males (males:females = 4:1)
Prevalence rare
Prognosis benign, increased risk of malignancy
Treatment 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;[1] however, it is not considered a pre-malignant condition.[2][3]

Urinary bladder with squamous metaplasia and squamous metaplasia of the urinary bladder redirect to this article.

General

  • Rare.[3]
  • Large age range (13-80 years).[1]
  • Predominantly males - almost 4:1 (27 males:7 females in one series[1]).

Treatment:

  • Follow-up is recommended.[3][4]

Note:

  • ‡ Non-keratinizing squamous metaplasia can be considered normal and is relatively common in the trigone region of the bladder in women.[citation needed]

Microscopic

Features:

  • Squamous epithelium with hyperkeratosis or parakeratosis.
  • Negative for significant nuclear atypia.

DDx:

Sign out

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.

See also

References

  1. 1.0 1.1 1.2 Khan, MS.; Thornhill, JA.; Gaffney, E.; Loftus, B.; Butler, MR. (Nov 2002). "Keratinising squamous metaplasia of the bladder: natural history and rationalization of management based on review of 54 years experience.". Eur Urol 42 (5): 469-74. PMID 12429156.
  2. Kvist, E.; Sjølin, KE.; Laursen, H.; Orntoft, TF.; Sturmer, MA. (Jul 1992). "Squamous cell metaplasia of the bladder urothelium. A retrospective study of 36 patients.". APMIS 100 (7): 650-4. PMID 1379440.
  3. 3.0 3.1 3.2 Ahmad, I.; Barnetson, RJ.; Krishna, NS. (2008). "Keratinizing squamous metaplasia of the bladder: a review.". Urol Int 81 (3): 247-51. doi:10.1159/000151398. PMID 18931537.
  4. Benelli A, Varca V, Vaccaro C, Guzzo S, Nicola M, Onorati M, Gregori A, Di Nuovo F (May 2020). "Keratinizing squamous metaplasia of the bladder: Our experience and current approaches". Urologia 87 (2): 97–100. doi:10.1177/0391560318810197. PMID 30509153.