Difference between revisions of "Urinary bladder xanthoma"

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'''Urinary bladder xanthoma''', also '''[[xanthoma]] of the [[urinary bladder]]''', is a rare benign lesion of the bladder that occasionally may be clinically suspicious for malignancy.<ref name=pmid24810457>{{Cite journal  | last1 = Hassouna | first1 = H. | last2 = Broome | first2 = JD. | last3 = Swalem | first3 = K. | last4 = Manikandan | first4 = R. | title = Xanthoma of the urinary bladder: a rare benign condition which may be mistaken for malignancy. | journal = BMJ Case Rep | volume = 2014 | issue =  | pages =  | month =  | year = 2014 | doi = 10.1136/bcr-2014-203836 | PMID = 24810457 }}</ref>
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Urinary_bladder_xanthoma_--_intermed_mag.jpg
| Width      =
| Caption    = Urinary bladder xanthoma. [[H&E stain]].
| Synonyms  =
| Micro      = aggregate of foamy histiocytes in the lamina propria, no significant nuclear atypia
| Subtypes  =
| LMDDx      = [[signet ring cell carcinoma]], [[granular cell tumour]], [[malakoplakia]], [[xanthogranulomatous cystitis]], benign urothelium with mild atypia
| Stains    =
| IHC        = CD68 +ve, S-100 -ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[urinary bladder]] and other sites - see ''[[xanthoma]]''
| Assdx      = lipid disorders (hyperlipidemia)
| Syndromes  =
| Clinicalhx =
| Signs      = +/-hematuria
| Symptoms  = irritation
| Prevalence = very rare
| Bloodwork  =
| Rads      =
| Endoscopy  = patch or plaque, yellow, ill-defined border
| Prognosis  = benign
| Other      =
| ClinDDx    =
| Tx        =
}}
'''Urinary bladder xanthoma''', also '''[[xanthoma]] of the urinary bladder''' and '''bladder xanthoma''', is a rare benign lesion of the [[urinary bladder|bladder]] that occasionally may be clinically suspicious for [[malignancy]].<ref name=pmid24810457>{{Cite journal  | last1 = Hassouna | first1 = H. | last2 = Broome | first2 = JD. | last3 = Swalem | first3 = K. | last4 = Manikandan | first4 = R. | title = Xanthoma of the urinary bladder: a rare benign condition which may be mistaken for malignancy. | journal = BMJ Case Rep | volume = 2014 | issue =  | pages =  | month =  | year = 2014 | doi = 10.1136/bcr-2014-203836 | PMID = 24810457 }}</ref>


==General==
==General==
*Rare.
*Rare - 17 cases in a larger multi-institutional study.<ref name=pmid25580863/>
*Like other [[xanthoma]]s may be associated with abnormal lipid profile.
*Like other [[xanthoma]]s may be associated with an abnormal lipid profile.


Presentation:<ref name=pmid25580863>{{Cite journal  | last1 = Yu | first1 = DC. | last2 = Patel | first2 = P. | last3 = Bonert | first3 = M. | last4 = Carlson | first4 = K. | last5 = Yilmaz | first5 = A. | last6 = Paner | first6 = G. | last7 = Magi-Galluzzi | first7 = C. | last8 = Lopez-Beltran | first8 = A. | last9 = Trpkov | first9 = K. | title = Urinary bladder xanthoma: a multi-institutional series of 17 cases. | journal = Histopathology | volume = 67 | issue = 2 | pages = 255-61 | month = Aug | year = 2015 | doi = 10.1111/his.12647 | PMID = 25580863 }}</ref>
Presentation:<ref name=pmid25580863>{{Cite journal  | last1 = Yu | first1 = DC. | last2 = Patel | first2 = P. | last3 = Bonert | first3 = M. | last4 = Carlson | first4 = K. | last5 = Yilmaz | first5 = A. | last6 = Paner | first6 = G. | last7 = Magi-Galluzzi | first7 = C. | last8 = Lopez-Beltran | first8 = A. | last9 = Trpkov | first9 = K. | title = Urinary bladder xanthoma: a multi-institutional series of 17 cases. | journal = Histopathology | volume = 67 | issue = 2 | pages = 255-61 | month = Aug | year = 2015 | doi = 10.1111/his.12647 | PMID = 25580863 }}</ref>
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*[[Granular cell tumour]].
*[[Granular cell tumour]].
*[[Malakoplakia]].
*[[Malakoplakia]].
*Xanthogranulomatous cystitis.
*[[Xanthogranulomatous cystitis]].
*Mild urothelial atypia (esp. large umbrella cells) in normal [[urothelium]].
*Mild urothelial atypia (esp. large umbrella cells) in normal [[urothelium]].
===Images===
<gallery>
Image: Urinary bladder xanthoma -- low mag.jpg | UBX - low mag.
Image: Urinary bladder xanthoma -- intermed mag.jpg | UBX - intermed. mag.
Image: Urinary bladder xanthoma -- high mag.jpg | UBX - high mag.
Image: Urinary bladder xanthoma -- very high mag.jpg | UBX - very high mag.
Image: Urinary bladder xanthoma - alt -- intermed mag.jpg | UBX - intermed. mag.
Image: Urinary bladder xanthoma - alt -- high mag.jpg | UBX - high mag.
</gallery>


==IHC==
==IHC==
Line 29: Line 71:
*S-100 -ve  
*S-100 -ve  
**Positive in granular cell tumour.
**Positive in granular cell tumour.
==Sign out==
<pre>
Urinary Bladder Lesion, Transurethral Excision:
- Xanthoma, see comment.
- Negative for carcinoma in situ and negative for invasive malignancy.
COMMENT:
These lesions may be associated with metabolic abnormalities. A lipid
profile is suggested if not done recently. 
</pre>


==See also==
==See also==

Latest revision as of 14:57, 4 November 2022

Urinary bladder xanthoma
Diagnosis in short

Urinary bladder xanthoma. H&E stain.
LM aggregate of foamy histiocytes in the lamina propria, no significant nuclear atypia
LM DDx signet ring cell carcinoma, granular cell tumour, malakoplakia, xanthogranulomatous cystitis, benign urothelium with mild atypia
IHC CD68 +ve, S-100 -ve
Site urinary bladder and other sites - see xanthoma
Associated Dx lipid disorders (hyperlipidemia)
Signs +/-hematuria
Symptoms irritation
Prevalence very rare
Endoscopy patch or plaque, yellow, ill-defined border
Prognosis benign

Urinary bladder xanthoma, also xanthoma of the urinary bladder and bladder xanthoma, is a rare benign lesion of the bladder that occasionally may be clinically suspicious for malignancy.[1]

General

  • Rare - 17 cases in a larger multi-institutional study.[2]
  • Like other xanthomas may be associated with an abnormal lipid profile.

Presentation:[2]

  • Hematuria.
  • Irritation.

Gross

Features:[2]

  • Flat lesion (patch or plaque) with ill-defined border, yellow.

Microscopic

Features:

  • Aggregate of foamy histiocytes in the lamina propria.[2]
  • No significant nuclear atypia.

DDx:[2]

Images

  • UBX - low mag.

  • UBX - intermed. mag.

  • UBX - high mag.

  • UBX - very high mag.

  • UBX - intermed. mag.

  • UBX - high mag.

IHC

  • CD68 +ve.
  • S-100 -ve
    • Positive in granular cell tumour.

Sign out

Urinary Bladder Lesion, Transurethral Excision:
- Xanthoma, see comment.
- Negative for carcinoma in situ and negative for invasive malignancy.

COMMENT:
These lesions may be associated with metabolic abnormalities. A lipid 
profile is suggested if not done recently.

See also

References

  1. ↑ Hassouna, H.; Broome, JD.; Swalem, K.; Manikandan, R. (2014). "Xanthoma of the urinary bladder: a rare benign condition which may be mistaken for malignancy.". BMJ Case Rep 2014. doi:10.1136/bcr-2014-203836. PMID 24810457.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 Yu, DC.; Patel, P.; Bonert, M.; Carlson, K.; Yilmaz, A.; Paner, G.; Magi-Galluzzi, C.; Lopez-Beltran, A. et al. (Aug 2015). "Urinary bladder xanthoma: a multi-institutional series of 17 cases.". Histopathology 67 (2): 255-61. doi:10.1111/his.12647. PMID 25580863.
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