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This brief communication describes a rare spontaneous background lesion in the lower urinary tract of two male laboratory beagles. Proliferative lesions comprising a constellation of histological features consistent with polypoid cystitis were observed in the bladder of two adolescent dogs from a routine preclinical toxicology study. Both animals were clinically asymptomatic and had only minor alterations in urinalysis parameters. While chronic polypoid cystitis is well-recognized in adult pet dogs, this is the first reported case in purpose-bred laboratory beagles. An awareness of this uncommon background finding is important for toxicological pathologists to distinguish it from potential test article-related findings.

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Contrast-enhanced ultrasound (CEUS) can provide quantitative information on enhancement patterns and perfusion of lesions, based on time-intensity curves (TICs). No published studies have compared CEUS parameters in neoplastic and non-neoplastic urinary bladder lesions in dogs. The aim of the current prospective, pilot study was to quantitatively characterize the CEUS pattern of neoplastic and non-neoplastic urinary bladder lesions in dogs, assessing the influence of contrast arrival time (CAT) on the final appearance of the curves. Fourteen dogs with cyto-histopathological diagnoses were included (seven malignant and seven inflammatory lesions). B-mode ultrasound was performed followed by CEUS examination after an intravenous bolus injection of 0.04 mL/kg of contrast medium, and TICs were elaborated by dedicated software. Receiver operating characteristic curves (ROC) for each TIC parameter were obtained. Neoplastic lesions had subjectively shorter rise time (RT), time to peak (TTP) and fall time (FT) than inflammatory lesions. Based on ROC curve analyses, fall time ≥ 10.49 s was the most reliable parameter for diagnosing non-neoplastic disease in this small sample of dogs (area under the curve [AUC] 0.75, sensitivity 83.33%, specificity 66.67%). No difference was found between ROCs calculated for each parameter of TICs by adding or removing CAT. Results of the current study provide background for future, larger scale studies evaluating use of a CEUS FT threshold of 10.49 s as a possible discriminator for urinary bladder neoplastic lesions in dogs.

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Background: Polypoid cystitis is infrequently seen in noncatheterized patients, occasionally posing challenging treatment options. We present a rare case of polypoid cystitis with bilateral upper tract obstruction mimicking a bladder tumor, needing staged endoscopic management. Case Presentation: A 45-year-old Asian man with a bladder tumor presented with lower urinary tract symptoms. Subsequent transurethral resection of bladder tumor histology revealed polypoid cystitis. This had caused intramural edema and obstruction of the distal ureters that were managed with initial local resection, ureteral dilatation with a period of ureteral stenting, and oral steroids. Subsequent intravenous urogram and diuretic renogram showed resolution of obstruction and resolution of hydronephrosis. He also had mixed lower urinary tract symptoms and hematuria managed with combination of solifenacin, finasteride, and tamsulosin. Conclusion: Polypoid cystitis with ureteral obstruction needs to be considered in differentials of a bladder tumor, and management may include a combination of endoscopic resection, ureteral stenting, and in resistant cases oral steroids can be considered to aid resolution of inflammation in the absence of infection.

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A 21-year-old male with a history of Down's syndrome presented with hematuria and right flank pain. Computed Tomography (CT) of the abdomen/pelvis revealed right hydronephrosis and a right-sided pelvic vascular abnormality. Angiography revealed an arteriovenous malformation (AVM) fed by the right superior and inferior vesical arteries and nephrostogram showed a long segment of obstructed distal right ureter. Cystoscopy revealed erythema and edema of the right hemi-bladder and biopsy diagnosed polypoid cystitis. Treatment was performed by transarterial embolization with ethylene vinyl alcohol copolymer. Follow up cystoscopy and retrograde pyelography at 3 months post-procedure showed resolution of all visible pathology.

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Benign diseases of the bladder often present diagnostic challenges to practicing pathologists due to their diverse nature and ability to mimic a variety of epithelial or mesenchymal neoplasms. Categories of benign bladder disease include infectious cystitis, noninfectious cystitis, reactive proliferative processes, and benign processes that secondarily involve the bladder. An understanding of the key clinical and morphologic features of these lesions and the useful ancillary techniques specific for these entities is critical to the correct diagnosis of these lesions. This article reviews the key features of these benign bladder diseases and highlights methods to distinguish these lesions from other benign and malignant processes involving the bladder.

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Polypoid cystitis is an unusual benign lesion characterized by the edema, congestion and inflammation elevating the vesical mucosa into papillary projections. It is rare in the absence of one of the following 3 recognizable causes: indwelling catheters, vesical fistula or chronic bladder irritation. We report a case of a rapidly growing, huge polypoid cystitis without identifiable cause in a 17-year-old female, who was managed by cystectomy with uterus preservation and orthotopic bladder substitution.

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