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Updated: Feb 12, 2026
07:57
An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
Published on: June 24, 2025
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Iatrogenic pathology of the urinary bladder
Antonio Lopez-Beltran1, Rodolfo Montironi2, Maria R Raspollini3
1Department of Pathology and Surgery, Faculty of Medicine, Cordoba E-14004, Spain.
Seminars in Diagnostic Pathology
|March 27, 2018
Summary
Urinary bladder treatments like chemotherapy and immunotherapy can cause urothelial atypia, mimicking cancer. Differentiating these therapy-related changes from true neoplasia is crucial for accurate diagnosis.
Area of Science:
- Uropathology
- Oncology
- Medical Toxicology
Background:
- Urinary bladder malignancies frequently undergo treatment with intravesical immunotherapy, chemotherapy, and neoadjuvant systemic chemotherapy.
- These therapeutic interventions can induce reactive morphologic changes in the urothelium.
- These changes may be mistaken for urothelial carcinoma in situ (CIS), dysplasia, or invasive neoplasia.
Purpose of the Study:
- To highlight therapy-related atypia in the urinary bladder.
- To differentiate treatment-induced urothelial changes from neoplastic conditions.
- To discuss the utility of immunohistochemistry in distinguishing reactive changes.
Main Methods:
- Review of common intravesical and systemic therapies for bladder cancer.
- Identification of drugs causing urothelial atypia (e.g., Mitomycin C, BCG, platinum-based chemotherapy, cyclophosphamide, ketamine).
- Discussion of immunohistochemical markers (CK20, p53, CD44) for differentiating reactive atypia from CIS.
Main Results:
- Therapeutic procedures and certain systemic drugs can cause significant atypical changes in the urothelium.
- These changes can mimic urothelial CIS, dysplasia, or invasive neoplasia.
- Immunohistochemistry may aid in distinguishing therapy-related atypia from CIS.
Conclusions:
- Therapy-related atypia is a common finding in the urinary bladder after treatment.
- Accurate differentiation from neoplastic changes is essential for patient management.
- Immunohistochemical markers can assist pathologists in the post-therapy setting.
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