Bladder wall thickening (differential)

Differential diagnosis for bladder wall thickening depends on whether the bladder is adequately distended. The bladder wall may be thickened if:

• >3 mm when distended
• >5 mm when nondistended

If the bladder is not distended, then it is difficult to exclude artifactual thickening from a collapsed bladder

If the bladder wall is adequately distended, then a differential may be developed based on whether the bladder is diffusely thickened or focally thickened:

Diffuse bladder wall thickening

• bladder outlet obstruction
• neurogenic bladder
• infectious cystitis
• cystitis from radiation or chemotherapy

Focal bladder wall thickening

• urothelial cell carcinoma of the bladder (transitional cell carcinoma)
• artifact: blood products / clot
  • will not enhance on postcontrast CT or MRI; no vascularity on color Doppler
  • may be adherent to the bladder wall, like tumor, but clot is more likely to have a concave margin, unlike tumor
• other bladder neoplasm
  • squamous cell carcinoma of the bladder
  • adenocarcinoma of the bladder
  • bladder lymphoma
  • Local invasion of adjacent tumor
  • small cell bladder tumor
  • bladder paraganglioma
  • bladder wall leiomyoma
  • neurofibroma / neurofibromatosis 
• (cystitis): more commonly diffuse than focal, but may mimic neoplasm
• adjacent inflammatory process (e.g. diverticulitis)
• cystitis cystica and cystitis glandularis
  • may mimic bladder cancer
• amyloidosis of the bladder: rare
• malacoplakia of the bladder: rare
• bladder endometriosis

Siehe auch:

• Harnblasendivertikel
• Harnblasenkarzinom
• Urachuskarzinom
• Balkenblase
• Karzinom in einem Blasendivertikel