MRI Findings of Inverted Urothelial Papilloma of the Bladder
Mitsuru TakeuchiKohei SasaguriTaku NaikiAkihito MitsumoriHirotoshi ItoJunko TakahamaKaori YamadaNagaaki MarugamiTakahiro TsuboyamaYoshihiro OkumuraYoshimitstu OhgiyaNoriyasu KawaiKenjiro KohriYuta Shibamoto
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MRI Findings of Inverted Urothelial Papilloma of the BladderMitsuru Takeuchi1, Kohei Sasaguri2, Taku Naiki3, Akihito Mitsumori4, Hirotoshi Ito5, Junko Takahama6, Kaori Yamada7, Nagaaki Marugami6, Takahiro Tsuboyama8, Yoshihiro Okumura9, Yoshimitstu Ohgiya10, Noriyasu Kawai3, Kenjiro Kohri3 and Yuta Shibamoto1Audio Available | ShareKeywords:
Inverted Papilloma
Sinonasal papillomas are benign epithelial neoplasms arising from Schneiderian mucosa. The three subtypes, exophytic, oncocytic, and inverted (inverted papilloma [IP]), should be distinguished from one another histopathologically. This study (1) highlights the histopathological and clinical differences between the Schneiderian papilloma subtypes and (2) identifies clinical features that potentially predict papilloma subtypes.A retrospective review was performed of patients with Schneiderian papillomas over an 11-year period.Seventy patients with sinonasal papillomas who underwent sinus surgery were identified. There were 50 (71%) male and 20 (29%) female subjects diagnosed at an average age of 53 years (range, 13-80 years). Exophytic (n = 25), oncocytic (n = 9), and IP (n = 37) were identified. IP was associated with transformation into squamous cell carcinoma in three (8%) cases and dysplasia in three (8%) cases. Neither oncocytic nor exophytic subtypes were associated with dysplasia or malignancy. On multivariate analysis of potential predictors of papilloma subtype, history of chronic rhinosinusitis (CRS) and location of papilloma were significantly associated with papilloma subtype. Using classification and regression tree model, papilloma subtypes can be predicted based on presence or absence of CRS and papilloma location with nominal 82.4% accuracy.The inverted and exophytic type are the most common sinonasal papillomas, with the inverted type having an 8% rate of malignant transformation in this study. In contrast, the oncocytic type was not associated with dysplasia or malignancy in our series despite reports in the literature indicating malignant potential. History of CRS and papilloma location can provide clues to the histological subtype, which is important for surgical planning and patient counseling.
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Objective To analysis the expressions of HGF and c-Met in different stages of intranasal inverted papilloma and try to explore the effects of HGF and c-Met in the malignant transformation of nasal inverted papilloma.Methods 30 cases with confirmed malignant papilloma and 55 cases with nasal inverted papilloma in our hospital from Jan 2005 to Dec 2010 were received as experimental objects.All the patients underwent endoscopic removal of diseased tissue.The expressions of HGF and c-Met in nasal inverted papilloma tissue,adjacent tissues and malignant tissues were determined by immunohistochemical method,and the stain score of each sample was calculated.The expressions of HGF and c-Met in different stages of nasal inverted papilloma were analyzed.Results The staining scores of HGF and c-Met in malignant tissue were higher than those in nasal inverted papilloma tissues and the adjacent tissues,the expressions of HGF and c-Met in the adjacent tissues were the minimum.Expressions of HGF and c-Met in T1 stage of inverted papilloma were significantly lower than those in T3 stage(P 0.05,P 0.01) and T4 stage(both P 0.01).Conclusions The expressions of HGF and c-Met in nasal inverted papilloma were related to its stage,and may contribute to the malignant transformation of it.
Inverted Papilloma
Malignant Transformation
Stain
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Four new cases of inverted urothelial papillomas are described and added to the 47 cases previously reported in the literature. Three papillomas present benign gross and microscopic characteristics. The fourth case, however, demonstrates inverted papilloma and papillary transitional cell carcinoma in a single polypoid lesion. This papillary malignant transformation, not previously observed in inverted papillomas, cautions against overconfidence in benign nature of inverted papilloma.
Inverted Papilloma
Malignant Transformation
Gross hematuria
Papillary tumor
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Clinical studies of 36 patients with papilloma of the nasal and sinonasal sinuses were performed. We treated 25 men and 11 women with an average age of 55.1 years. Chief complaints were nasal obstruction. Histology showed 11 cases of squamous cell papilloma and 25 cases of sinonasal papilloma. Sinonasal papilloma were classified into three histopathological types : exophitic papilloma, inverted papilloma and cylindrical cell papilloma. In this study, inverted papilloma was the most common type. Inverted papilloma occurred primarily in the internal wall of the maxillary sinus. The recurrence rate was 9.7% (3 cases), one case was squamous cell papilloma with sinonasal papilloma, and two cases were inverted papilloma. Four cases (11.1 % ) showed malignant transformation.
Inverted Papilloma
Malignant Transformation
Sinus (botany)
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Inverted Papilloma
Malignant Transformation
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The aim of this work was to analyze the occurrence of inverted papilloma within the nose and paranasal sinuses, the extent of lesions and the clinical course in the patients who underwent endoscopic surgery.Between the years of 2006-2012, at the Department of Otolaryngology and Laryngological Oncology, 2295 patients were subjected to surgery due to paranasal sinus diseases. The material was based on their past medical histories. The analysis includes the age and gender of the patients, the type of surgery, and results of histopathological examinations. A surgical procedure covered the paranasal sinuses with lesions diagnosed in CT. The qualified patients had inverted papilloma in histopathological results.Among 2295 patients who were operated because of chronic inflammatory changes, inverted papilloma was histopathologically diagnosed in 49 cases. In 16 patients with inverted papilloma, inflammatory changes were present on one side only, while in 33 cases inverted papilloma was confirmed histopathologically on one side. The analysis of age and gender of the study group showed that the highest occurrence of inverted papilloma was in patients over 50 years of age. In the majority of the studied cases, inverted papilloma spread in the middle nasal concha and the maxillary or ethmoid sinus.In surgery, the endoscopic technique allows for an effective removal of inverted papilloma from the nose and paranasal sinuses. According to the authors, endoscopy is the most valuable method for post-operative monitoring of recurrent inverted papilloma.
Inverted Papilloma
Sinus (botany)
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Abstract Objective To evaluate the pathological features and variations of sinonasal inverted and oncocytic papillomas and correlate the microscopic findings with the clinical behavior. Study Design A retrospective review and pathological assessment. Methods A retrospective review and pathological assessment were performed on 40 patients with a diagnosis of inverted papilloma treated by the senior author (w.l.) between 1994 and 2001. Results Forty cases were identified and reviewed. Seven patients developed recurrences (18%), and four underwent malignant transformations (10%). Pathological assessment revealed 34 (85%) inverted papillomas and 6 (15%) oncocytic schneiderian papillomas. Dysplasia was present in 26 cases (65%), including 9 cases (22%) of high‐grade dysplasia (moderate to severe). Metaplasia of the sinonasal mucosa adjacent to inverted papillomas and oncocytic schneiderian papillomas was seen in 18 (45%) cases. Recurrence developed in two patients with oncocytic schneiderian papillomas (33%) and five patients with inverted papillomas (15%). Four cases (10%) of carcinoma ex papilloma were seen; one arose from oncocytic schneiderian papilloma (17%), and three arose from inverted papilloma (9%). Oncocytic schneiderian papilloma was more often mixed with typical inverted papilloma, rather than presenting in its pure form. Conclusions Although oncocytic schneiderian papilloma is uncommon relative to inverted papilloma, the results suggest that they have higher rates of both recurrence and malignant transformation. The common admixture of oncocytic schneiderian papilloma with inverted papilloma speaks for a common etiological factor of these two lesions. A larger number of cases for analysis would be necessary to confirm the trend noted in our data. Nonetheless, pathological findings consistent with oncocytic schneiderian papilloma should be explicit in any classification system and justify aggressive treatment and careful postoperative surveillance.
Inverted Papilloma
Malignant Transformation
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Objective: To investigate the expression of human papilloma virus in the sinonasal inverted papilloma and papillous squamous cell carcinoma,and to study the correlation of the expression of HPV with development and progression of the sinonasal inverted papilloma.Methods: HPV(wide-spectrum model)protein expression in 49 paraffin tissue specimen of sinonasal,including inverted papilloma,papillous squamous cell carcinoma and 11 paraffin tissue specimen of chronic inflammations(nasal polypus)were detected using immunohistochemical EnVision two step method.Results: HPV in the inverted papilloma and papillous squamous cell carcinoma was observed,the overall positive rate of HPV was 34.7%(17/49).Expression of HPV was not found in 11 chronic inflammations(nasal polypus).The positive rate of HPV was 38.2%(13/34)in the sinonasal inverted papilloma,26.7%(4/15)in the papillous squamous cell carcinoma.The correlation of the sinonasal inverted papilloma and the papillous squamous cell carcinoma was not statistically significant in the positive rate of HPV.The correlation of chronic inflammation(nasal polypus)and inverted papilloma,papillous squamous cell carcinoma was statistically significant in the positive rate of HPV(P0.05).Conclusion: HPV infection is likely to have close correlation with the development of sinonasal inverted papilloma and papillous squamous cell carcinoma.Nevertheless,the correlation needs further research between HPV infection and carcinogenesis of sinonasal inverted papilloma.
Inverted Papilloma
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To investigate the histopathological characteristics of inverted papillomas of the urinary bladder, including the possibility of malignant transformation, we studied the indicators of cellular proliferation activity in 7 inverted papillomas of the bladder including two cases of malignant inverted papilloma of the bladder. PCNA expression rates in two cases of malignant inverted papilloma were higher than in benign inverted papillomas. Mean numbers of AgNORs per nucleus in malignant inverted papillomas were much more than in benign inverted papillomas. The c-erbB-2 oncoprotein was expressed only in malignant inverted papillomas. These results suggest that PCNA expression rate, mean number of AgNORs per nucleus and c-erB-2 oncoprotein expression may be merited as good indicators to detect the inverted papilloma with more proliferative and aggressive lesions, and with the potential of malignant transformation.
Inverted Papilloma
Malignant Transformation
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Inverted Papilloma
Malignant Transformation
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