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Published on: July 28, 2012
Urinary bladder sinuses: a novel morphologic lesion with clinical and pathologic significance
Kien T Mai1, Eric C Belanger, Bojana Djordjevic
1Department of Pathology and Laboratory Medicine, The Ottawa Hospital and University of Ottawa, Ontario, Canada. ktmai@ottawahospital.on.ca
Applied Immunohistochemistry & Molecular Morphology : AIMM
|April 13, 2012
Summary
Urinary bladder sinuses (UBS) are invaginations of the bladder lining. Recognizing these structures is crucial to prevent misdiagnosis of bladder cancer.
Area of Science:
- Uropathology
- Anatomical Pathology
Background:
- Urinary bladder sinuses (UBS) are characterized by segmental mucosal and muscularis mucosa invaginations.
- These invaginations extend into the submucosa (superficial UBS) or muscularis propria (deep UBS).
Purpose of the Study:
- To describe the pathological features of urinary bladder sinuses (UBS).
- To differentiate UBS from other bladder pathologies.
- To highlight the clinical significance of UBS in avoiding misdiagnosis.
Main Methods:
- Review of radical cystectomy specimens.
- Analysis of transurethral resection of the bladder specimens.
- Histopathological examination of bladder biopsies.
Main Results:
- Superficial UBS and deep UBS were distinguished from cystitis cystica, embryonic remnants, intramural ureters, and diverticula.
- Superficial UBS were identified in 13/20 transurethral resection specimens and 15/50 radical cystectomy specimens.
- Deep UBS were found in 23/50 radical cystectomy specimens, often associated with superficial UBS.
- Intraepithelial neoplasia occurred in UBS mucosa in 10 cases, potentially mimicking invasive carcinoma.
- UBS were associated with mucosal redundancy and muscularis propria hypertrophy, mimicking muscle-invasive cancer.
Conclusions:
- Accurate identification of urinary bladder sinuses (UBS) is essential.
- Recognition of UBS aids in preventing pathological and clinical over-staging of bladder malignancies.
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