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1:
Bladder - Amyloidosis
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Comments: This is an example of primary amyloidosis localized to bladder. There is pink, amorphous material throughout the lamina propria. In some cases, ureters and urethra may also be involved. J Urol 2000 Jun; 163(6):1867-8.
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2:
Bladder - Amyloidosis
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Comments: The amorphous material may invite foreign-body giant cell reaction and calcification (not seen here). Vascular invovlement is less common in Primary Amyloidosis but more prominent in secondary involvement of bladder.
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3:
Bladder - Endocervicosis
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Comments: Endocervicosis is an uncommon mullerian lesion consisting of irregularly-shaped glands proliferating deep in the bladder wall. Patients often give history of having undergone caesarean section.
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4:
Bladder - Endocervicosis
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Comments: The glands in endocervicosis are lined by a single layer of columnar epithelium with abundant clear cytoplasm and small hyperchromatic nuclei.
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5:
Bladder - Endocervicosis
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Comments: The nuclei are bland and the lumen contains pale mucinous secretion. The term Mullerianosis has been applied when two or more of the following are present: endocervicosis, endometriosis, and endosalpingosis. Mod Pathol 9;(7):731-737.
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6:
Bladder - Endocervicosis
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Comments: Occasionally, the glands distended with mucin rupture as seen here. Mucin extravasation invites stromal response which may mimic desmoplasia associated with infiltrating cancer. The lining epithelial cells in this gland have become flattened due to compression by mucin.
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7:
Bladder - Inflammatory Pseudotumor
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Comments: This example of inflammatory pseudotumor shows proliferation of spindle cells in a background of myxoid matrix containing scattered inflammatory cells. The biopsy is from the bladder of a paraplegic patient with indwelling catheter.
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8:
Bladder - Inflammatory Pseudotumor
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Comments: This bladder biopsy shows myofibroblastic cells proliferating in the lamina propria. Some cells have plump hyperchromatic nuclei. Inflammatory cells are scattered in edematous stroma.
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9:
Bladder - Inflammatory Pseudotumor
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Comments: Note the resemblance to post-operative spindle cell nodule (next case). Features favoring inflammatory pseudotumor over sarcoma include 1) lack of significant nuclear atypia and 2) lack of necrosis at the tumor-detrusor interface in muscle-invasive cases. Mod Pathol 2001 Oct; 14(10):1043-51.
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10:
Post-Op Spindle Cell Nodule
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Comments: Post-operative spindle cell nodule consists of intersecting bundles of myo-fibroblastic cells in myxoid matrix. Increased mitotic activity, inflammatory cells, and hemorrhage are often present. Patients usually give history of surgery or instrumentation of urinary tract.
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