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.