Radiation or chemotherapy cystitis with "pseudocarcinomatous" features

The American Journal of Surgical Pathology
Theresa Y Chan, Jonathan I Epstein

Abstract

The features of radiation or chemotherapy cystitis mimicking invasive urothelial cancer are not widely known. A search of the consultation files from our institution between January 1996 and September 2003 identified 20 patients with bladder biopsies showing cystitis mimicking invasive urothelial cancer. The mean age at diagnosis was 69 years (range, 40-85 years); 80% were males. Complete history was not available in 1 patient. Seventeen patients had a history of pelvic irradiation (15 prostate cancer and 2 endometrial cancer). Two patients had systemic chemotherapy (1 metastatic colon cancer and 1 mixed connective tissue disease). All patients presented with hematuria. The mean time from radiation and/or chemotherapy to presentation was 27 months (range, 0-84 months). All cases showed epithelial proliferation that mimicked invasive cancer within the lamina propria, with marked proliferation seen in 45% of cases. Mild to moderate nuclear pleomorphism was seen in all cases. A characteristic feature was the presence of pseudoinvasive urothelial nests wrapping around the vessels associated with fibrin deposition. Most cases did not show any mitoses (75%). Ulceration was seen in 39% of cases. All cases showed some degree of hemorrh...Continue Reading

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Citations

Jun 6, 2009·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Robert H Young
Dec 29, 2007·The American Journal of Surgical Pathology·Zhaoli Lane, Jonathan I Epstein
Jun 30, 2012·Archives of Pathology & Laboratory Medicine·Lara Rabih Harik, Kathleen Mary O'Toole
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