Sunday, June 12, 2011

Calcifications in the Urinary Bladder Wall

Differential considerations for urinary bladder wall calcifications include:
  • Schistosomiasis: The most frequent cause of bladder wall calcification. Intense inflammation causes fibrosis and subsequent submucosal calcification of the dead ova trapped in the lamina propria of the urinary bladder.
  • Tuberculosis: Seen in 1O%-20% of patients with late genitouninany tuberculosis. It is usually the result of a descending infection, and extensive tuberculous changes are usually present in the kidneys and ureters by the time calcifications are seen on radiographs.
  • Primary carcinoma: Less than 1% of bladder calcifications due to tumor are visible on radiographs. Calcification is most commonly present in epithelial lesions (transitional cell and squamous cell), but may also be seen in leiomyosarcoma, hemangioma, neuroblastoma, and osteosarcoma.
  • Alkaline encrusted cystitis: May see calcifications on radiographs in a small percentage of cases. The calcifications may be linear, flocculent, or nodular.
  • Cyclophosphamide (Cytoxan)-induced cystitis: Due to bladder necrosis.
  • Radiation cystitis:
  • Amyloidosis: The rarest cause of bladder wall calcification. Submucosal calcifications may be arranged in sheets or discrete nodular masses.
Cystoscopy with biopsy is almost always necessary for confirmation and to rule out bladder neoplasia.

References

Pollack HM, Banner MP, Martinez LO, Hodson CJ. Diagnostic considerations in urinary bladder wall calcification. AJR Am J Roentgenol. 1981 Apr;136(4):791-7.

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