Intestinal Metaplasia of the Bladder

摘要

Intestinal metaplasia of the bladder, or cystitis glandularis of the intestinal type (CGIT), is denned by the presence of intestinal type epithelium in the bladder. CGIT may be focal or diffuse; it is thought to be reactive process in response to urothelial injury such as chronic infection or irritation, as seen in patients with a neurogenic bladder, long-standing stone disease or long-term catheterization. Patients typically present with voiding complaints such as hematuria, muscosuria, dysuria, urgency or obstructive symptoms.Although CGIT may be confined to surface epithelium, it more typically involves the underlying lamina propria. It has a predilection for the bladder neck and trigone. Grossly, the lesion may be flat and inconspicuous, or it may be a readily evident mucosal abnormality, with prominent edema and inflammation. Infrequently, an exuberant proliferation results in a nodule or a papillary or polypoid lesion, suspicious for malignancy (fig. 1). Occasionally a mass may be evident on computerized tomography or ultrasound.