Cystitis glandularis

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Cystitis glandularis
Diagnosis in short

Cystitis glandularis. H&E stain.
LM nests of urothelium within the lamina propria with cyst formation; lining cells are glandular (cuboidal and/or columnar epithelium); +/-goblet cells; nests should not extend into the muscularis propria
LM DDx cystitis cystica, nested variant of urothelial carcinoma, tubular adenoma of the urinary bladder, adenocarcinoma in situ of the urinary bladder
Site urinary bladder - see urothelium
Prevalence uncommon
Prognosis benign
Cystitis glandularis
External resources
EHVSC 10173

Cystitis glandularis is an uncommon type of inflammatory process that afflicts the urinary bladder (cystitis).

Cystitis cystica et glandularis and pyelitis cystica et glandularis redirect to here.

General

  • Benign.[1]
    • No increased risk of malignancy on follow-up in an older paper with a cohort of 136 patients.[2]
    • An older series of 53 patients with intestinal metaplasia suggests it is not a significant risk for cancer.[3]
  • Can be thought of as cystitis cystica with mucin-secreting cells lining the cystic spaces.[4]
  • When seen in conjunction with cystitis cystica it is called cystitis cystica et glandularis.

Note:

  • There are case reports of urethritis glandularis - the same lesion in the urethra.[5][6]

Microscopic

Features:[7]

  • Nests of urothelium within the lamina propria with cyst formation, i.e. lumens are present.
  • Cyst lining cells are cuboidal and/or columnar epithelium.
    • Produce mucin.
  • +/-Goblet cells, i.e. intestinal metaplasia.[4]

Note:

  • Nests should not extend into the muscularis propria.

DDx:

Images

  • CCG - very low mag.

  • CCG - low mag.

  • CCG - intermed mag.

  • CCG - high mag.

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Urinary Bladder Lesion, Transurethral Resection:
	- Cystitis cystica et cystica glandularis. 
	- NEGATIVE for dysplasia and NEGATIVE for malignancy.

Block letters

URINARY BLADDER NECK, BIOPSY:
- CYSTITIS CYSTICA ET GLANDULARIS.
- NEGATIVE FOR MALIGNANCY.

Micro

The sections show urothelial mucosa with bland nests within the lamina propria with cyst formation. The stroma is edematous and has a mixed inflammatory infiltrate consisting of plasma cells, eosinophils, lymphocytes and neutrophils.

See also

References

  1. ↑ Yi, X.; Lu, H.; Wu, Y.; Shen, Y.; Meng, Q.; Cheng, J.; Tang, Y.; Wu, F. et al. (Oct 2014). "Cystitis glandularis: A controversial premalignant lesion.". Oncol Lett 8 (4): 1662-1664. doi:10.3892/ol.2014.2360. PMID 25202387.
  2. ↑ Smith AK, Hansel DE, Jones JS (May 2008). "Role of cystitis cystica et glandularis and intestinal metaplasia in development of bladder carcinoma". Urology 71 (5): 915–8. doi:10.1016/j.urology.2007.11.079. PMID 18455631.
  3. ↑ Corica FA, Husmann DA, Churchill BM, Young RH, Pacelli A, Lopez-Beltran A, Bostwick DG (September 1997). "Intestinal metaplasia is not a strong risk factor for bladder cancer: study of 53 cases with long-term follow-up". Urology 50 (3): 427–31. doi:10.1016/S0090-4295(97)00294-X. PMID 9301710.
  4. ↑ 4.0 4.1 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 304. ISBN 978-0781765275.
  5. ↑ Chan, YM.; Ka-Leung Cheng, D.; Nga-Yin Cheung, A.; Yuen-Sheung Ngan, H.; Wong, LC. (Dec 2000). "Female urethral adenocarcinoma arising from urethritis glandularis.". Gynecol Oncol 79 (3): 511-4. doi:10.1006/gyno.2000.5968. PMID 11104631.
  6. ↑ Yin, G.; Liu, YQ.; Gao, P.; Wang, XH. (Aug 2007). "Male urethritis glandularis: case report.". Chin Med J (Engl) 120 (16): 1460-1. PMID 17825180.
  7. ↑ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1028. ISBN 0-7216-0187-1.
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