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. 2020 Oct-Dec;36(4):297-302.
doi: 10.4103/iju.IJU_261_20. Epub 2020 Oct 1.

Incidence of adenocarcinoma bladder in patients with cystitis cystica et glandularis: A retrospective study

Amit Agrawal  1 , Deepak Kumar  1 , Aditya A Jha  2 , Puneet Aggarwal  3
Affiliations

Incidence of adenocarcinoma bladder in patients with cystitis cystica et glandularis: A retrospective study

Amit Agrawal et al. Indian J Urol. 2020 Oct-Dec.

Abstract

Introduction: Cystitis cystica et glandularis (CCG) is a hyper proliferative condition, likely representing a local immune response to chronic inflammatory stimulus. It has been hypothesized as a potential precursor of adenocarcinoma; however, a definite association has not been demonstrated. We aimed to determine whether CCG is a precursor to malignancy and to study the correlation of its two histological variants: the typical and the intestinal metaplasia (IM) type CCG.

Materials and methods: In this retrospective study, all the cases of CCG diagnosed and treated between January 2012 and December 2019 were analyzed. All the cases were followed up cystoscopically and biopsies were taken if the lesion persisted. The development of adenocarcinoma during the follow-up was noted. The patients were divided into two groups based on the histological subtype, i.e., the typical type and the IM type, and the two groups were also compared in terms of presentation, cystoscopic appearance, and development of adenocarcinoma.

Results: A total of 64 patients, with 52 in the typical and 12 in the IM group were analyzed. The commonest symptom was hematuria (59.38%), followed by irritative bladder symptoms (51.56%). The median follow-up period was 5 years and 5 months (range: 7-96 months) and no patient progressed to adenocarcinoma. On comparing the two groups, the lesions weresignificantly more extensive in the IM group (50% vs. 15.38%). However, there were no differences in the symptoms or the development of malignancy between the two groups.

Conclusions: At a median of 5 years and 5 months of follow up, CCG (including the IM-type) did not show any increase in the risk of malignancy.

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Conflict of interest statement

Conflicts of interest: There are no conflicts of interest.

Figures

Figure 1
Figure 1
Cystitis cystica et glandularis showing a typical columnar lined subepithelial glandular metaplasia
Figure 2
Figure 2
Cystitis cystica et glandularis with intestinal metaplasia showing metaplasia of the columnar lined cells into goblet cells with mucin
See this image and copyright information in PMC

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