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Polypoid-Papillary Cystitis

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  • Non-specific inflammatory lesion characterized by lamina propria edema and mucosal polypoid or papillary projections.
  • Most often seen with indwelling catheters (80%) and vesical fistulas.
  • Cystoscopy shows friable edematous irregular mucosa with multiple small polypoid (<5 mm) nodules (image A).

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  • Histology:
    • Early lesion consists of broad based edematous papillae with tapered end lined by normal urothelium (polypoid cystitis) (image B), (image C), & (image D).
    • With time, polyp undergoes stromal fibrosis (papillary cystitis).
    • Accompanying acute and chronic inflammation can be seen.
  • Benign lesion with no risk for malignant progression.
  • DDX:
    • Papillary urothelial neoplasms: papillae are slender, delicate, can be more complex and exhibit branching with increasing grade, and shows range of urothelial dysplasia.