July 11, 2014

Focal Urinary Bladder Wall Thickening


Axial and sagittal-reformatted CT images show focal thickening of the posterior wall of the urinary bladder (arrows) with increased enhancement relative to normal bladder wall. 

Differential Diagnosis

  • Tumor (benign, malignant, metastasis)
  • Adherent clot
  • Infection/inflammation (TB, cystitis cystica/glandularis, malakoplakia, schistosomiasis)
  • Trauma (mural hematoma)
  • Extravesical pathologies (spread of extravesical inflammation or tumor, endometriosis)
Facts
  • Transitional cell carcinoma accounts for most focal bladder masses
  • Most of the time it is impossible to distinguish tumor from other causes of focal wall abnormality and cystoscopy is necessary
Our case: Transitional cell carcinoma in a 73-year-old female

Reference

Patel U. Imaging And Urodynamics Of The Lower Urinary Tract. Springer 2010.
Bhargava. Ultrasound Differential Diagnosis. Jaypee Brothers Publishers, 2005.

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