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papillary urothelial hyperplasia

Sunday 19 February 2017

Definition: The urothelial lining is arranged in finger-like papillary formations enclosing a fibrovascular core. The urothelium may be thickened but lacks cytologic atypia.

Papillary urothelial hyperplasia is most frequently encountered in patients with a prior history of a papillary urothelial neoplasm.

Images

- papillary urothelial hyperplasia

Microscopy

Urothelium lining the papillary folds is thickened but there is no cytologic atypia. Papillary urothelial hyperplasia is sometimes discovered during the workup for hematuria. Such patients should receive close follow-up. The long-term biologic behavior of de novo papillary hyperplasia is uncertain. It is presumed to be a precursor to low-grade papillary urothelial tumors.

Papillary hyperplasia may show increased vascularity of the lamina propria in the vicinity of the lesion. The urothelial lining does not appear to be thickened.

Differential diagnosis

The main difference between papillary urothelial hyperplasia and low-grade papillary urothelial neoplasm is the lack of complex branching architecture of the papillary fronds in the former. Minimal branching in an occasional papillary structure is allowed in papillary hyperplasia.

See also

- urothelial hyperplasia

- urothelial papilloma