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proliferation outside the primary mu¨ llerian system is called
mu¨ llerianosis
[11,12]
. This lesion usually involves the
detrusor as well as the subepithelial connective tissue of
the posterior wall.
The differential diagnosis includes cystitis glandularis,
cystitis cystica, and nephrogenic adenoma
[4,5]
. Cystitis
glandularis and cystitis cystica are located in the bladder
mucosa and do not involve the muscularis propria. Normal
urothelium is present in some glands. Nephrogenic adeno-
ma is characterized by a tubulocystic pattern. Ciliated cells
and mucinous cells are not present. It can involve the
muscularis propria.
5.
Conclusions
The excellent paper by Leone Roberti Maggiore et al, with
comments by Fauconnier et al in the same issue of
European
Urology
[12]
, has given us the chance to briefly report here
the full spectrum of benign and malignant mu¨ llerian lesions
in the bladder, of which BE is one and probably the most
widely known—or even the only one known—among
clinicians and pathologists. Our aim with this letter and
histological images was to acquaint clinicians (and pathol-
ogists) with mu¨ llerian lesions in the bladder.
Conflicts of interest:
The authors have nothing to disclose.
References
[1]
Leone Roberti Maggiore U, Ferrero S, Candiani M, et al. Bladder endometriosis: a systematic review of pathogenesis, diagnosis, treatment, impact on fertility, and risk of malignant transformation. Eur Urol 2017;71:790–807.
[2]
Humphrey PA. Endometriosis, endocervicosis and mu¨ llerianosis of the bladder. J Urol 2014;192:1523–4.
[3]
Young RH, Clement PB. Mu¨ llerianosis of the urinary bladder. Mod Pathol 1996;9:731–7.[4] Oliva E. Tumor-like lesions and benign histologic mimickers of
bladder cancer.
http://uscapknowledgehub.org/site /100th/pdf/ companion13h03.pdf.
[5] Young RH. The difficult diagnosis in the urinary bladder: a selective
consideration, mu¨ llerian and mu¨ llerian-like conditions.
http:// uscapknowledgehub.org/site /98th/pdf/companion13h05.pdf .[6]
Al-Khawaja M, Tan PH, MacLennan GT, et al. Ureteral endometri- osis: clinicopathological and immunohistochemical study of 7 cases. Hum Pathol 2008;39:954–9.
[7]
Oliva E, Amin MB, Jimenez R, Young RH. Clear cell carcinoma of the urinary bladder: a report and comparison of four tumors of mullerian origin and nine of probable urothelial origin with discussion of histo- genesis and diagnostic problems. Am J Surg Pathol 2002;26:190–7.
[8]
Miller EM, Sun Y, Richardson I, Frimer M. Vesical clear cell adeno- carcinoma arising from endometriosis: a mullerian tumor, indis- tinguishable from ovarian clear cell adenocarcinoma. Gynecol Oncol Rep 2016;18:8–10.[9]
Clement PB, Young RH. Endocervicosis of the urinary bladder. A report of six cases of a benign mu¨ llerian lesion that may mimic adenocarcinoma. Am J Surg Pathol 1992;16:533–42.[10] Patel A, Desai P, Malczewski F, Stephens D. Mu¨ llerianosis of the
urinary bladder: a rare and problematic bladder tumour. BMJ Case
Rep. In press.
http://dx.doi.org/10.1136/bcr-2016-218772.
[11]
Stanimir M, ChiuT ¸ u LC, Wese S, et al. Mu¨ llerianosis of the urinary bladder: a rare case report and review of the literature. Rom J Morphol Embryol 2016;57(2 Suppl):849–52.
[12]
Fauconnier A, Aubry G, Fritel X. Bladder endometriosis: a rare but challenging condition. Eur Urol 2017;71:808–10.Rodolfo Montironi
a,
*
Silvia Gasparrini
a
Antonio Lopez-Beltran
b
Liang Cheng
c
Francesco Massari
d
Francesco Montorsi
e
Marina Scarpelli
a
a
Section of Pathological Anatomy, Polytechnic University of the Marche
Region, School of Medicine, United Hospitals, Ancona, Italy
b
Pathology Service, Champalimaud Clinical Center, Lisbon, Portugal
c
Department of Pathology and Laboratory Medicine, Indiana University
School of Medicine, Indianapolis, IN, USA
d
Division of Oncology, S. Orsola-Malpighi Hospital, Bologna, Italy
e
Unit of Urology/Division of Oncology, Urological Research Institute, IRCCS
Ospedale San Raffaele, Milan, Italy
*Corresponding author. Pathological Anatomy, Polytechnic University of
the Marche Region, School of Medicine, United Hospitals, Via Conca 71,
I–60126 Ancona, Italy. Tel. +39 071 5964830; Fax: +39 071 889985.
E-mail address:
r.montironi@univpm.it(R. Montironi).
May 15, 2017
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