Metaplastic Conditions in The Bladder in Patient With Epidermolysis Bullosa

Epidermolysis bullosa is a rare inherited muco-cutaneous disorder that sometimes presents with genitourinary involvement. Herein we report the case of an 11-year-old girl with a history of junctional epidermolysis bullosa who was admitted with urological symptoms. On cystoscopy, suspected bullous bladder lesions were observed. Mesonephroid, intestinal and squamous metaplasia is reported here for the first time.

Key words:
Urinary Bladder; Epidermolysis Bullosa; Metaplasia

Authorship

Kenan Yilmaz Correspondence address: Kenan Yilmaz, MD, Fevzi Mercan Children's Hospital, Erciyes University Faculty of Medicine, Postal code: 38039, Kayseri, Turkey, Fax: 90 3524375825, E-mail: kenanylmz68@hotmail.com

Department of Pediatric Nephrology, Faculty of Medicine, Erciyes University, Kayseri, TurkeyErciyes UniversityTurkeyKayseri, TurkeyDepartment of Pediatric Nephrology, Faculty of Medicine, Erciyes University, Kayseri, Turkey

Deniz Demirci

Department of Urology, Faculty of Medicine, Erciyes University, Kayseri, TurkeyErciyes UniversityTurkeyKayseri, TurkeyDepartment of Urology, Faculty of Medicine, Erciyes University, Kayseri, Turkey

Numan Baydilli

Department of Urology, Faculty of Medicine, Erciyes University, Kayseri, TurkeyErciyes UniversityTurkeyKayseri, TurkeyDepartment of Urology, Faculty of Medicine, Erciyes University, Kayseri, Turkey

Sinan Nazlim

Department of Pathology, Faculty of Medicine, Erciyes University, Kayseri, TurkeyErciyes UniversityTurkeyKayseri, TurkeyDepartment of Pathology, Faculty of Medicine, Erciyes University, Kayseri, Turkey

Correspondence address: Kenan Yilmaz, MD, Fevzi Mercan Children's Hospital, Erciyes University Faculty of Medicine, Postal code: 38039, Kayseri, Turkey, Fax: 90 3524375825, E-mail: kenanylmz68@hotmail.com

CONFLICT OF INTEREST

None declared.

SCIMAGO INSTITUTIONS RANKINGS

Department of Urology, Faculty of Medicine, Erciyes University, Kayseri, TurkeyErciyes UniversityTurkeyKayseri, TurkeyDepartment of Urology, Faculty of Medicine, Erciyes University, Kayseri, Turkey

Figures

Figures (2)

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Figure 1
Epidermolysis bullosa patient's skin biopsy (A, B) and Epidermolysis bullosa patient's bladder biopsy. The bladder epithelium exhibits marked metaplastic changes (C, D, and E). (A, B) There are marked subepidermal blisters of noninflammatory type. The epidermis shows focal spongiosis. Mild dermal fibrosis and sparse inflammatory infiltrate in the dermis is observed. Hematoxylin and eosin stain, original magnification x100; (C) Intestinal metaplasia of the urinary bladder. A complex glandular structure lined by mucin-producing columnar cells. Hematoxylin and eosin stain, original magnification x 400; (D) Mesonephroid metaplasia of the urinary bladder. A complex clustering of microcystic and tubular formations lined by cuboidal to flattened cells in edematous stroma. Hematoxylin and eosin stain, original magnification x 400; (E) Squamous metaplasia of the urinary bladder. Note characteristics of squamous nests. Hematoxylin and eosin stain, original magnification x 400.

Thumbnail

Figure 2
Cystoscopic images of lesions at bladder neck and right bladder wall.

Figure 1 Epidermolysis bullosa patient's skin biopsy (A, B) and Epidermolysis bullosa patient's bladder biopsy. The bladder epithelium exhibits marked metaplastic changes (C, D, and E). (A, B) There are marked subepidermal blisters of noninflammatory type. The epidermis shows focal spongiosis. Mild dermal fibrosis and sparse inflammatory infiltrate in the dermis is observed. Hematoxylin and eosin stain, original magnification x100; (C) Intestinal metaplasia of the urinary bladder. A complex glandular structure lined by mucin-producing columnar cells. Hematoxylin and eosin stain, original magnification x 400; (D) Mesonephroid metaplasia of the urinary bladder. A complex clustering of microcystic and tubular formations lined by cuboidal to flattened cells in edematous stroma. Hematoxylin and eosin stain, original magnification x 400; (E) Squamous metaplasia of the urinary bladder. Note characteristics of squamous nests. Hematoxylin and eosin stain, original magnification x 400.

Figure 2 Cystoscopic images of lesions at bladder neck and right bladder wall.

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Metaplastic Conditions in The Bladder in Patient With Epidermolysis Bullosa

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[1] Correspondence address: Kenan Yilmaz, MD, Fevzi Mercan Children's Hospital, Erciyes University Faculty of Medicine, Postal code: 38039, Kayseri, Turkey, Fax: 90 3524375825, E-mail: kenanylmz68@hotmail.com