Inverted urothelial papilloma of the urinary bladder with focal papillary pattern: a previously undescribed feature |
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| Authors: | Jorge Albores-Saavedra Fredy Chable-Montero Oscar X. Hernández-Rodríguez Daniel Montante-Montes de Oca Arturo Angeles-Angeles |
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| Affiliation: | 1. GynaePath, Douglass Hanly Moir Pathology, Sydney, Australia;2. Department of Obstetrics, Gynaecology and Neonatology, The University of Sydney;3. Repromed, Adelaide, SA, Australia;4. IVF Australia, Sydney, Australia;5. Genea, Sydney, NSW, Australia;1. Department of Urology, University of Miami Miller School of Medicine, Miami, FL;2. Department of Urology, St. George Hospital, Kogarah, New South Wales, Australia;3. Aphs National Capital Private Hospital Pharmacy, Garran, Australia;4. Department of Anatomical Pathology, South Eastern Area Laboratory Service, St. George Hospital, Kogarah, New South Wales, Australia;5. Cancer Research Program and Garvan Institute of Medical Research, Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia;6. School of Medicine and Health Sciences, University of Western Sydney, Campbelltown, New South Wales, Australia;7. University of New South Wales, Kensington, New South Wales, Australia;1. Division of Neonatology and Pediatric Intensive Care, Department of Pediatrics, University Hospital RWTH Aachen, Aachen, Germany;2. Institute of Human Genetics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany;3. Kiel Paediatric Tumor Registry, Department of Paediatric Pathology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany;4. Department of Pediatric Urology, University Medical Center Regensburg, Hospital St. Hedwig, Regensburg, Germany;5. Division of Pediatric Urology, Department of Urology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany;6. Division of Pediatric Nephrology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany;1. Ministry of Health, Numune Teaching and Research Hospital, Department of Urology, Adana, Turkey;2. Ministry of Health, Numune Teaching and Research Hospital, Department of Pathology, Adana, Turkey;3. Department of Urology, Gazi University School of Medicine, Ankara, Turkey;4. Ministry of Health, Cukurova Askim Tufekci State Hospital, Department of Urology, Adana, Turkey;5. Ministry of Health, Haseki Teaching and Research Hospital, Department of Urology, Istanbul, Turkey |
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| Abstract: | We report 2 examples of inverted urothelial papillomas with a focal papillary pattern. Both patients, a 43-year-old man and a 13-year-old adolescent boy, presented with hematuria. In addition to the characteristic trabecular endophytic growth pattern and bland cytologic features, the tumors showed focal papillary architecture in the endophytic component. Because of this feature, both tumors were misinterpreted as papillary urothelial carcinoma with inverted pattern. However, the papillary fronds were similar to those of exophytic urothelial papilloma. They were lined by 3 to 8 layers of normal-appearing urothelial cells often covered by a continuous or discontinuous layer of superficial (umbrella) cells. Although follow-up is limited, the 2 patients have remained asymptomatic. The recognition of papillary structures in urothelial inverted papilloma broadens the morphological spectrum of this unusual benign urothelial neoplasm and complicates the microscopic interpretation of urothelial lesions with inverted growth patterns. Surgical pathologists should be aware of this unusual feature of inverted urothelial papilloma of the urinary bladder to avoid misinterpretation with urothelial carcinoma with an inverted pattern. |
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