Presentation
Dysuria.
Patient Data
Ultrasound of pelvis shows polypoidal wall thickening of the posterior wall of urinary bladder in the region of trigone.
CT scan shows polypoidal wall thickening of urinary bladder along the trigone region, projecting into the lumen of the bladder. There is involvement of bilateral uretero-vesical junctions (UVJ) but no obvious occlusion and no significant hydroureteronephrosis. Mild enhancement is noted following contrast. There is no associated definite extravesical extension.
Case Discussion
Suspicion of malignancy was raised by the imaging findings and cystoscopy with biopsy was recommended. Cystoscopic guided biopsy of the lesion showed it to be cystitis glandularis with intestinal metaplasia. The lesion was limited to lamina propria. No atypia / mucous extravasation seen.
Cystitis glandularis (CG) is a proliferative disorder of the urinary bladder in which there is glandular metaplasia of the transitional cells lining the urinary bladder. It is not an uncommon condition and often identified on biopsies and cystectomies. It usually occurs in the trigone of the urinary bladder.
The intestinal subtype of CG has been proposed to be a precursor of adenocarcinoma. However, certain authors have considered CG to be a chronic and quiescent histologic lesion without any clinical significance.
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