Benign Tumors of the Bladder Benign Tumors of the Bladder Epithelial Metaplasia Leukoplakia Inverted Papilloma Papilloma Nephrogenic Adenoma
Cystitis Cystica and Glandularis Leiomyoma Epithelial Metaplasia Metaplasia (Greek: "change in form") - Reversible replacement of one differentiated cell type with another mat ure differentiated cell type - The change from one type of cell to another may generally be a part of norm
al maturation process or caused by some sort of abnormal stimulus. - In simplistic terms, it is as if the original cells are not robust enough to withst and the new environment, and so they change into another type more suited to the new environment. If the stimulus that caused metaplasia is remov ed or ceases, tissues return to their normal pattern of differentiation. - Metaplasia is not synonymous with dysplasia and is not directly considered c arcinogenic. It is also contrasted with heteroplasia, which is the abnormal gr owth of cytologic and histologic elements without a stimulus.
Epithelial metaplasia - focal areas of transformed urothelium wit h normal nuclear and cellular architecture surrounded by norm al urothelium usually located on the trigone Squamous metaplasia - Nonkeratinizing squamous metaplasia - Keratinizing squamous metaplasia Glandular metaplasia
Present in 85% of reproductive-age women and 75% of menopaus al women in trigone where it's considered a normal (non-metapl astic) finding; occurrence outside this area is considered metapla stic. May cause urinary urgency/frequency (pseudomembranous trigon itis), but has no risk for progression to neoplasia. Also seen in male receiving hormonal therapy for prostate cancer. Histology: squamous cells usually have bubbly appearance due t
o accumulation of glycogen that produces cytoplasmic clearing Epithelial Metaplasia Squamous Metaplasia Keratinizing squamous metaplasia Associated with long-standing mucosal irritation, such as prolon ged catheterization, lithiasis, chronically infected bladder, dive
rticula or schistosomiasis. More common in patients with spinal injury or paraplegia. Can be visualized as gray to white patches or plaques. Histology: hyperkeratotic squamous epithelium Can be associated with concurrent or subsequent carcinomas wit h squamous differentiation, and suggested as precursor lesion for squamous cell carcinoma. ? !!
Epithelial Metaplasia Glandular Metaplasia - Clumps of raised red areas that appear inflammatory and are of ten confused for cancer. - Glandular metaplasia can extensively involve the bladder, parti cularly the trigone, but biopsy is not required. Treatment is un necessary, and a preventive agent has not been identified.
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