• Jungyo Suh


There are numerous benign and malignant tumors occurring in the bladder. Epithelial metaplasia, leukoplakia, inverted papilloma, papilloma, nephrogenic adenoma, cystitis cystica, and leiomyoma are common conditions of benign tumor in the bladder. Inverted papilloma is histologically defined as inverted growth pattern of normal urothelial cell. Behavior of inverted papilloma shows benign feature with 1% incidence of tumor recurrence and not related to urothelial carcinoma; transurethral resection of the tumor is the treatment of choice. Urothelial papilloma was considered as Ta grade 1 malignant tumor before 1998, when the World Health Organization (WHO) changed bladder cancer classification. Nephrogenic adenoma is a rare condition caused by chronic irritation of urothelium. Cystitis cystica and cystitis glandularis commonly affect the normal bladder and are also associated with chronic inflammatory condition. Leiomyoma occurs most commonly in childbearing-aged women, and if patient complains of severe pain, surgical removal of tumor is needed.


Urothelial carcinoma Histologic subtype Carcinoma in situ Lymphovascular invasion Histologic variant T1 sub-staging 


  1. 1.
    Chalasani V, Chin JL, Izawa JI. Histologic variants of urothelial bladder cancer and nonurothelial histology in bladder cancer. Can Urol Assoc J. 2009;3:193–8.CrossRefGoogle Scholar
  2. 2.
    Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65:87–108. Scholar
  3. 3.
    Grignon DJ. The current classification of urothelial neoplasms. Mod Pathol. 2009;22:S60–9. Scholar
  4. 4.
    Sylvester RJ, van der Meijden A, Witjes JA, Jakse G, Nonomura N, Cheng C, et al. High-grade Ta urothelial carcinoma and carcinoma in situ of the bladder. Urology. 2005;66:90–107. Scholar
  5. 5.
    Casey RG, Catto JWF, Cheng L, Cookson MS, Herr H, Shariat S, et al. Diagnosis and management of urothelial carcinoma in situ of the lower urinary tract: a systematic review. Eur Urol. 2015;67:876–88. Scholar
  6. 6.
    Mathieu R, Lucca I, Rouprêt M, Briganti A, Shariat SF. The prognostic role of lymphovascular invasion in urothelial carcinoma of the bladder. Nat Rev Urol. 2016;13:471–9. Scholar
  7. 7.
    Bolenz C, Herrmann E, Bastian PJ, Michel MS, Wülfing C, Tiemann A, et al. Lymphovascular invasion is an independent predictor of oncological outcomes in patients with lymph node-negative urothelial bladder cancer treated by radical cystectomy: a multicentre validation trial. BJU Int. 2010;106:493–9. Scholar
  8. 8.
    Shariat SF, Svatek RS, Tilki D, Skinner E, Karakiewicz PI, Capitanio U, et al. International validation of the prognostic value of lymphovascular invasion in patients treated with radical cystectomy. BJU Int. 2010;105:1402–12. Scholar
  9. 9.
    Berman DM, Kawashima A, Peng Y, Mackillop WJ, Siemens DR, Booth CM. Reporting trends and prognostic significance of lymphovascular invasion in muscle-invasive urothelial carcinoma: a population-based study. Int J Urol. 2015;22:163–70. Scholar
  10. 10.
    Sonpavde G, Khan MM, Svatek RS, Lee R, Novara G, Tilki D, et al. Prognostic risk stratification of pathological stage T3N0 bladder cancer after radical cystectomy. J Urol. 2011;185:1216–21. Scholar
  11. 11.
    Aziz A, Shariat SF, Roghmann F, Brookman-May S, Stief CG, Rink M, et al. Prediction of cancer-specific survival after radical cystectomy in pT4a urothelial carcinoma of the bladder: development of a tool for clinical decision-making. BJU Int. 2016;117:272–9. Scholar
  12. 12.
    Türkölmez K, Tokgöz H, Reşorlu B, Köse K, Bedük Y. Muscle-invasive bladder cancer: predictive factors and prognostic difference between primary and progressive tumors. Urology. 2007;70:477–81. Scholar
  13. 13.
    Olsson H, Hultman PER, Rosell J, Jahnson S. Population-based study on prognostic factors for recurrence and progression in primary stage T1 bladder tumours. Scand J Urol. 2013;47:188–95. Scholar
  14. 14.
    Cho KS, Seo HK, Joung JY, Park WS, Ro JY, Han KS, et al. Lymphovascular invasion in transurethral resection specimens as predictor of progression and metastasis in patients with newly diagnosed T1 bladder urothelial cancer. J Urol. 2009;182:2625–31. Scholar
  15. 15.
    Miyake M, Gotoh D, Shimada K, Tatsumi Y, Nakai Y, Anai S, et al. Exploration of risk factors predicting outcomes for primary T1 high-grade bladder cancer and validation of the Spanish Urological Club for Oncological Treatment scoring model: long-term follow-up experience at a single institute. Int J Urol. 2015;22:541–7. Scholar
  16. 16.
    Brimo F, Wu C, Zeizafoun N, Tanguay S, Aprikian A, Joao J, et al. Prognostic factors in T1 bladder urothelial carcinoma: the value of recording millimetric depth of invasion, diameter of invasive carcinoma, and muscularis mucosa invasion. Hum Pathol. 2013;44:95–102. Scholar
  17. 17.
    Kim HS, Kim M, Jeong CW, Kwak C, et al. Presence of lymphovascular invasion in urothelial bladder cancer specimens after transurethral resections correlates with risk of upstaging and survival: a systematic review and meta-analysis. Urol Oncol. 2014;32:1191–9. Scholar
  18. 18.
    Green DA, Rink M, Hansen J, Cha EK, Robinson B, Tian Z, et al. Accurate preoperative prediction of non-organ-confined bladder urothelial carcinoma at cystectomy. BJU Int. 2013;111:404–11. Scholar
  19. 19.
    Seisen T, Compérat E, Léon P, Roupret M. Impact of histological variants on the outcomes of nonmuscle invasive bladder cancer after transurethral resection. Curr Opin Urol. 2014;24:524–31. Scholar
  20. 20.
    Moschini M, D’Andrea D, Korn S, Irmak Y, Soria F, Compérat E, et al. Characteristics and clinical significance of histological variants of bladder cancer. Nat Rev Urol. 2017;14:651–68. Scholar
  21. 21.
    Lopez-Beltran A, Cheng L. Histologic variants of urothelial carcinoma: differential diagnosis and clinical implications. Hum Pathol. 2006;37:1371–88. Scholar
  22. 22.
    van Rhijn BW, van der Kwast TH, Alkhateeb SS, Fleshner NE, van Leenders GJ, Bostrom PJ, et al. A new and highly prognostic system to discern T1 bladder cancer substage. Eur Urol. 2012;61:378–84. Scholar
  23. 23.
    Martin-Doyle W, Leow JJ, Orsola A, Chang SL, Bellmunt J. Improving selection criteria for early cystectomy in high-grade T1 bladder cancer: a meta-analysis of 15,215 patients. J Clin Oncol. 2015;33:643–50. Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Jungyo Suh
    • 1
  1. 1.Department of UrologySeoul National University HospitalSeoulSouth Korea

Personalised recommendations