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transitional papilloma
Description
Transitional papilloma, also known as urothelial papilloma, is a rare benign epithelial neoplasm that affects the urinary bladder and other parts of the urinary tract.
Characteristics:
- It is a type of tumor that grows in a papillary fashion, with delicate fibrovascular cores lined by normal urothelium.
- The tumor is typically small and can be found on the surface of the bladder or in the ureters.
- It is usually solitary but can occur in multiple locations.
Clinical Features:
- Patients with transitional papilloma are often asymptomatic, but some may experience symptoms such as hematuria (blood in the urine), urinary frequency, or urgency.
- The tumor is typically benign and does not invade surrounding tissues.
- However, there is a small risk of malignant transformation, especially if the tumor is large or has irregular borders.
Histological Features:
- Histologically, transitional papilloma is characterized by a papillary growth pattern with fibrovascular cores lined by normal urothelium.
- The tumor cells are typically cuboidal or columnar in shape and have a low nuclear-to-cytoplasmic ratio.
- There may be some cellular atypia, but the overall architecture of the tumor is well-organized.
Imaging Features:
- On imaging studies such as CT scans with contrast, transitional papilloma appears as a filling defect or a polypoid lesion with a thin stalk.
- MRI can also show a similar appearance, with the tumor appearing as a non-papillary surface and thin stalk.
References:
- [1] Alrashidy et al. (2017) - "Immunohistochemical expression of cytokeratin 20, p53, and Ki-67 in urothelial papilloma cases" [3]
- [6] Heathcote JG (2012) - "Transitional papilloma (inverted papilloma, Schneiderian papilloma)" [6]
- [11] UROTHELIAL PAPILLOMA. (no author) - "Urothelial papilloma is a rare benign papillary urothelial neoplasm" [11]
Note: The above information is based on the search results provided and may not be an exhaustive description of transitional papilloma.
Additional Characteristics
- rare benign epithelial neoplasm
- grows in a papillary fashion
- typically small and solitary
- can occur in multiple locations
- usually asymptomatic, but may experience symptoms such as hematuria, urinary frequency or urgency
- benign and does not invade surrounding tissues
- small risk of malignant transformation if large or has irregular borders
- characterized by a papillary growth pattern with fibrovascular cores lined by normal urothelium
- cuboidal or columnar in shape and have a low nuclear-to-cytoplasmic ratio
- may be some cellular atypia but overall architecture is well-organized
- appears as a filling defect or polypoid lesion with a thin stalk on imaging studies
Signs and Symptoms
Transitional papilloma, also known as bladder papilloma, can present with a range of signs and symptoms. Here are some possible manifestations:
- Hematuria: This is the most common presenting symptom in both pediatric and adult patients, according to [3]. Hematuria refers to the presence of blood in the urine.
- Unilateral nasal obstruction: This symptom may occur due to the tumor's location in the lacrimal sac region, as described in [6].
- Anosmia: This is a loss of smell that can be associated with transitional papilloma, as mentioned in [6].
- Headache: A headache can also be a nonspecific sign and symptom of this condition, as noted in [6].
- Epistaxis: This refers to bleeding from the nose, which can be a presenting feature of malignancy, according to [4].
- Palpable mass: A palpable mass in the lacrimal sac region is highly suggestive of malignancy, as stated in [4].
It's worth noting that these symptoms may not always be present, and some cases may be asymptomatic. However, when they do occur, they can significantly impact a patient's quality of life.
References:
[3] - Hematuria is the most common presenting symptom in pediatric and adult patients. [4] - Epistaxis and a palpable mass in the lacrimal sac region are highly suggestive of malignancy. [6] - The clinical picture presents nonspecific signs and symptoms, such as unilateral nasal obstruction, anosmia, and headache.
Diagnostic Tests
Transitional papilloma, also known as urothelial papilloma, is a type of benign tumor that affects the urinary system. Diagnostic tests for this condition are crucial in confirming the diagnosis and ruling out other potential issues.
Light Microscopy: This is the primary diagnostic tool for transitional papilloma. A biopsy sample is taken from the affected area and examined under a microscope to confirm the presence of transitional cells with preserved nuclear polarity [11].
Imaging Studies: Imaging tests such as ultrasound (USG) can help identify papillary or elevated lesions in the urinary system, which may indicate the presence of a transitional papilloma [14]. However, these tests are not definitive and require further investigation.
Cystoscopy: This procedure involves using a cystoscope to visually examine the inside of the bladder. It can help identify papillary or elevated lesions, which may be indicative of a transitional papilloma [14].
Biopsy: A biopsy sample is taken from the affected area and examined under a microscope to confirm the diagnosis of transitional papilloma.
It's worth noting that transitional papillomas are generally benign and have a low recurrence risk. However, it's essential to consult with a healthcare professional for an accurate diagnosis and treatment plan.
References: [11] Kouiss Y (2024) Bladder papilloma diagnosis relies on light microscopy, with hematuria as a primary symptom, often in younger patients. Recurrence risk is low, ... [14] Imaging: ultrasound (USG) · Cystoscopy: papillary / elevated lesions, variable size, often unifocal (Mod Pathol 2003;16:623) · Biopsy / ...
Treatment
Treatment Options for Transitional Papilloma
Transitional papilloma, also known as urothelial papilloma, is a type of non-cancerous tumor that affects the lining of the urinary system. While it's not cancerous, treatment may still be necessary to prevent potential complications.
- Cytotoxic agents: Topical application of cytotoxic agents such as thiotepa, mitomycin, and doxorubicin have been used to treat transitional papilloma. These medications work by killing abnormal cells in the affected area [1].
- Immunotherapy or inflammatory therapy: Intravesical therapy involves delivering medication directly into the bladder through a catheter. This approach can be effective for treating transitional papilloma, especially when combined with other treatments [6].
- Anktiva and BCG combination: Anktiva is used in conjunction with BCG (Bacillus Calmette-Guérin) to treat non-muscle invasive bladder cancer (NMIBC), including transitional papilloma. This treatment approach has shown promising results, especially for patients who haven't responded well to BCG alone [7].
Key Considerations
- Prevention: While there's no cure for transitional papilloma, preventing its progression is crucial. Regular check-ups with a healthcare provider can help identify potential issues early on.
- Treatment goals: The primary goal of treatment is to eliminate the tumor and prevent recurrence.
References
[1] Cytotoxic agents have been used to treat various types of urothelial tumors, including transitional papilloma [1]. [6] Intravesical therapy can be an effective approach for treating transitional papilloma, especially when combined with other treatments [6]. [7] Anktiva and BCG combination has shown promising results in treating NMIBC, including transitional papilloma [7].
Recommended Medications
- BCG (Bacillus Calmette-Guérin)
- Anktiva
- cytotoxic agents
- doxorubicin
- Doxorubicin
- Thiotepa
- mitomycin
- Mitomycin
💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.
Differential Diagnosis
The differential diagnosis for transitional papilloma, also known as urothelial papilloma, involves several conditions that can mimic its appearance and characteristics.
Key considerations:
- Papillary urothelial neoplasm of low malignant potential (PUNLMP): This is a type of non-invasive tumor that can be difficult to distinguish from transitional papilloma. However, PUNLMP tends to have more complex papillary structures and a higher cell thickness than transitional papilloma [2][4].
- Inverted papilloma: This is another type of benign neoplasm that can be mistaken for transitional papilloma. Inverted papillomas tend to have a more solid appearance and may not have the characteristic papillary projections seen in transitional papilloma [3][7][8].
- Florid von Brunn nests, cystitis cystica, and cystitis glandularis: These are all types of benign lesions that can be found in the urinary bladder and may resemble transitional papilloma. However, they tend to have a more complex histological appearance than transitional papilloma [12].
- Nephrogenic metaplasia, carcinoid, and paraganglioma: These are all rare tumors that can be mistaken for transitional papilloma due to their similar appearance on imaging studies. However, they tend to have distinct histological features that can help differentiate them from transitional papilloma [12].
Key points:
- The differential diagnosis of transitional papilloma is complex and requires careful consideration of several conditions.
- Papillary urothelial neoplasm of low malignant potential (PUNLMP) and inverted papilloma are two key conditions that can be mistaken for transitional papilloma.
- A thorough histological examination and clinical evaluation are essential to accurately diagnose transitional papilloma.
References:
[1] Not provided [2] Context 2 [3] Context 3 [4] Context 4 [5] Context 5 [6] Not provided [7] Context 7 [8] Context 8 [9] Not provided [10] Not provided [11] Not provided [12] Context 12
Additional Differential Diagnoses
- Papillary urothelial neoplasm of low malignant potential (PUNLMP)
- Florid von Brunn nests, cystitis cystica, and cystitis glandularis
- Nephrogenic metaplasia, carcinoid, and paraganglioma
- inverted papilloma
Additional Information
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- disease_ontology
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- DOID:2670
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- DOID:2670
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- UMLS_CUI:C0334266
- oboInOwl#hasExactSynonym
- transitional cell papilloma, benign
- rdf-schema#label
- transitional papilloma
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- http://www.w3.org/2002/07/owl#Class
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- https://w3id.org/def/predibionto#has_symptom_9899
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