Leukoplakia of the urinary tract

Leukoplakia of the urinary tract is a squamous metaplasia of the urothelium (keratinization).

Clinical presentation

Clinically the condition presents with hematuria in one-third of cases, dysuria, frequency and nocturia, and thus it can mimic cystitis. Passage of the desquamated keratinized epithelial layers can also occur.

Pathology

The condition is associated with infection in the majority of cases (80%) and calculi in 40%. In decreasing order of frequency, it can occur in the bladder, the renal pelvis and the ureter.

Macroscopically, white patches may be seen, hence the name.

Radiographic features

Mucosal thickening and multiple filling defects.

Treatment and prognosis

Leukoplakia is considered a premalignant condition. There is an association with bladder neoplasia in 25% of cases.

Differential diagnosis

• malakoplakia of the bladder
  • non-neoplastic chronic granulomatous lesions due to chronic infection by Escherichia coli in an immunocompromised patient, commonly diabetes mellitus or transplant recipients

• transitional cell carcinoma

• tuberculous urethritis
  • multifocal or long-segment strictures
  • calcification is commonly seen
• ureteritis cystica
  • reactive proliferative changes of the urothelium causing multiple small subepithelial cysts

Siehe auch:

• Malakoplakie des Harntraktes