Pathomorphological criteria for the differential diagnosis of leukoplakia and chronic recurrent papillomavirus cystitis

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Introduction: According to the literature of recent years, there has been an increased interest in non-oncological diseases of the bladder, between which differential diagnostics have to be carried out in order to determine a plan for the diagnosis and treatment of patients with these nosologies. There are often certain difficulties in the differential diagnosis of some forms of viral cystitis and leukoplakia

Objective: to determine pathomorphological criteria for the differential diagnosis of leukoplakia and chronic recurrent papillomavirus cystitis.

Materials and methods: The prospective study included 85 sexually active patients aged 20–45 years, who were divided into two groups depending on the etiological factor. Patients of group I (n=70) – with chronic recurrent cystitis (CRC) of papillomavirus (PV) etiology, group II (n=15) – with leukoplakia. All patients were examined in accordance with the recommendations of the European Association of Urology (EAU) and the Russian Society of Urology (ROU); an additional endoscopic examination of the bladder (cystoscopy) was performed, followed by a morphological examination of the bladder biopsy.

Results: A morphological examination of biopsy tissue in all patients of group I revealed koilocytic transformation of the urothelium combined with non-keratinizing metaplasia of the urothelium, and in patients of group II, in all cases, keratinizing metaplasia of the urothelium with hyperkeratosis was detected.

Conclusion: Morphological examination is the gold standard in differential leukoplakia and chronic recurrent papillomavirus cystitis

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Sobre autores

Kh. Ibishev

Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University» of the Ministry of Health of Russia

Autor responsável pela correspondência
Email: ibishev22@mail.ru
ORCID ID: 0000-0002-2954-842X

M.D., Dr. Sc. (Med), Full Prof., Prof. Dept. of Urology, Pediatric Urology & Reproductive Health

Rússia, Rostov-on-Don

T. Lapteva

State Autonomous Institution of the Rostov Region «Regional Consultative and Diagnostic Center» of the Ministry of Health of Russia

Email: Lto-96@yandex.ru
ORCID ID: 0000-0002-6544-6113

M.D., Pathologist, Pathology Division

Rússia, Rostov-on-Don

S. Todorov

Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University» of the Ministry of Health of Russia

Email: sertodorov@gmail.com
ORCID ID: 0000-0001-8476-5606

Dr. Sc. (Med.), Associate Professor of the Department of Operative Surgery, Clinical Anatomy and Pathological Anatomy, head of the morphological department of the clinic, pathologist of the highest category

Rússia, Rostov-on-Don

I. Goncharov

Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University» of the Ministry of Health of Russia

Email: ilagoncarov11250@gmail.com
ORCID ID: 0009-0005-0770-7230

resident of the Department of Urology and Human Reproductive Health (with a course of pediatric urology-andrology)

Rússia, Rostov-on-Don

A. Alkhashash

Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University» of the Ministry of Health of Russia

Email: Ahmadalhashash95@gmail.com
ORCID ID: 0009-0002-8983-3107

postgraduate student of the Department of Urology and Human Reproductive Health (with a course of pediatric urology-andrology)

Rússia, Rostov-on-Don

V. Mamedov

Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University» of the Ministry of Health of Russia

Email: mamedov1007@yandex.ru
ORCID ID: 0000-0001-5508-4510

M.O. Urologist, Postgraduate student, Dept. of Urology and Human Reproductive Health (with Podiatrie Urology and Andrology Course)

Rússia, Rostov-on-Don

Bibliografia

  1. Pandey T., Pandey S., Goel A., Aggarwal A. Leukoplakia of the urinary bladder: keratinising squamous metaplasia. BMJ Case Rep. 2018 Aug 27;2018: bcr2018227019.
  2. Lee P.J., Kuo H.C. High incidence of lower urinary tract dysfunction in women with recurrent urinary tract infections. Low Urin Tract Symptoms. 2020;12(1):33–40.
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  5. Ibishev Kh.S., Todorov S.S., Ismailov R.S. et al. Morphological study of the urothelium in the differential diagnosis of chronic recurrent lower urinary tract infection Urology. 2023;(5):16–21. Russian (Ибишев Х.С., Тодоров С.С., Исмаилов Р.С. и др. Морфологическое исследование уротелия в дифференциальной диагностике хронической рецидивирующей инфекции нижних мочевыводящих путей Урология. 2023;(5):16–21).
  6. Ibishev Kh.S., Mamedov V.K., Naboka Yu.L. et al. Cytological examination of urine in the differential diagnosis of recurrent lower urinary tract infection. Urologiia. 2023;(2):8–12. Russian (Ибишев Х.С., Мамедов В.К., Набока Ю.Л. и др. Цитологическое исследование мочи в дифференциальной диагностике рецидивирующей инфекции нижних мочевыводящих путей. Урология. 2023;(2):8–12).
  7. Krakhotkin D.V. The role of human papillomavirus infection in the development of recurrent lower urinary tract infection: specialty 14.01.23 “Urology”: dissertation for the degree of candidate of medical sciences. Krakhotkin Denis Valerievich, 2021:171 p. Russian (Крахоткин Д.В. Роль папилломавирусной инфекции в развитии рецидивирующей инфекции нижних мочевых путей: специальность 14.01.23 «Урология»: диссертация на соискание ученой степени кандидата медицинских наук. Крахоткин Денис Валерьевич, 2021; 171 с.)
  8. Ibishev Kh.S., Lapteva T.O., Krakhotkin D.V., Ryabenchenko N.N. The role of human papillomavirus infection in the development of recurrent lower urinary tract infection Urology. 2019;(5):136–139. Russian (Ибишев Х.С., Лаптева Т.О., Крахоткин Д.В., Рябенченко Н.Н. Роль папилломавирусной инфекции в развитии рецидивирующей инфекции нижних мочевыводящих путей Урология. 2019;(5):136–139).
  9. Ibishev Kh.S., Krakhotkin D.V., Mamedov E.A. et al. The place of immunotherapy in the treatment of recurrent cystitis. Bulletin of Urology. 2021;9(1):87–94. Russian (Ибишев Х.С., Крахоткин Д.В., Мамедов Э.А. и др. Место иммунотерапии в лечении рецидивирующего цистита. Вестник урологии. 2021;9(1):87–94).
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  12. Ibishev Kh.S., Krakhotkin D.V., Lapteva T.O. et al. Endoscopic and morphological signs of chronic recurrent papillomavirus cystitis. Urologiia. 2021;(3):45–49. Russian (Ибишев Х.С., Крахоткин Д.В., Лаптева Т.О. и др. Эндоскопические и морфологические признаки хронического рецидивирующего папилломавирусного цистита. Урология. 2021;(3):45–49).
  13. Lee P.J., Kuo H.C. High incidence of lower urinary tract dysfunction in women with recurrent urinary tract infections. Low Urin Tract Symptoms. 2020;12(1):33–40.
  14. Ibishev Kh.S., Krakhotkin D.V., Kogan M.I. et al. Patent No. 2723024 C1 Russian Federation, IPC G01N 33/48, A61B 10/00. method for differential diagnosis of chronic recurrent cystitis: No. 2020103808: application. 01/29/2020: publ. 06/08/2020 Russian (Ибишев Х.С., Крахоткин Д.В., Коган М.И. и др. Патент № 2723024 C1 Российская Федерация, МПК G01N 33/48, A61B 10/00. способ дифференциальной диагностики хронического рецидивирующего цистита: № 2020103808: заявл. 29.01.2020: опубл. 08.06.2020)

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2. Fig. 1. Cystoscopy. Exophytic formations of the bladder

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3. Fig. 2. Cystoscopy. Leukoplakia of the bladder

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4. Fig. 3. Morphological examination. Pathological restructuring of urothelial cells: papillomatous hyperplasia with signs of HIV infection (coilocytosis, discariasis). [N&E, uv. x200]

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5. Fig. 4. Morphological examination. Pathological restructuring of urothelial cells: squamous cell metaplasia with keratinization, hyperkeratosis [N&E, uv. XI00]

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6. Fig. 5. Morphological examination. Pathological restructuring of urothelial cells: squamous cell metaplasia with eosinophilic staining of the squamous hyperkeratotic (glycogenized) squamous epithelium [N&E, uv. X100]

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