Home Education AUAUniversity Education Products & Resources Pathology for Urologists Urinary Bladder Histoanatomic Abnormalities/Malformations Müllerian Lesions

Müllerian Lesions

Image A

Image B


  • Involves the GU tract in 1% of cases, mostly in the bladder.
  • Encountered in reproductive age females (ave. 35 years old) and very rarely, postmenopausal women receiving estrogen replacement or men receiving estrogen for treatment of prostate cancer.
  • About half of patients have prior pelvic surgery.
  • Involves mucosa, bladder wall or serosa.
  • Cystoscopy shows mucosal nodule with hemorrhage or is unremarkable if the lesion is away from mucosa.
  • Histology: requires presence of endometrial glands (G), stroma (S) and recent or old hemorrhage for diagnosis (image A).


  • Rare and encountered in females in their 40's or 50's.
  • Presence of endocervical-like glands in bladder muscular wall (mostly), mucosa or serosa.
  • Single layer of mucinous columnar cells with interspersed ciliated cells (image B).
  • Benign lesion, with no documented risk for malignant transformation.


  • Presence of tubal-like tubules and glands lined by ciliated cells in the bladder.
  • Encountered in reproductive age females.


  • Mixture of any of these lesions in the bladder.

Important not to misdiagnosis these lesions as adenocarcinoma involving the bladder.