Urinary bladder xanthoma

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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

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.