A Gamut of Astounding Diagnosis as Paraganglioma of Urinary Bladder: A Retrospective Study from North India

Background and Aim: Urinary bladder paraganglioma (UBPGL) is a rare neuroendocrine neoplasm, accounting for <0.05% of all bladder tumors and 0.7% of all paragangliomas. This study aimed to describe the histopathology of UBPGL, emphasizing the histologic attributes that may help pathologists recog...

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Main Authors: Nazia Manzoor Walvir, Aiffa Aiman, Inara Abeer, Mohammad Iqbal Lone, Shadab Maqsood
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Archives of Medicine and Health Sciences
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Online Access:https://journals.lww.com/10.4103/amhs.amhs_282_23
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author Nazia Manzoor Walvir
Aiffa Aiman
Inara Abeer
Mohammad Iqbal Lone
Shadab Maqsood
author_facet Nazia Manzoor Walvir
Aiffa Aiman
Inara Abeer
Mohammad Iqbal Lone
Shadab Maqsood
author_sort Nazia Manzoor Walvir
collection DOAJ
description Background and Aim: Urinary bladder paraganglioma (UBPGL) is a rare neuroendocrine neoplasm, accounting for <0.05% of all bladder tumors and 0.7% of all paragangliomas. This study aimed to describe the histopathology of UBPGL, emphasizing the histologic attributes that may help pathologists recognize this rare bladder tumor and aid in differentiation from urothelial malignancies and other tumors that may resemble paragangliomas. Materials and Methods: This retrospective observational study was conducted in the pathology department of a tertiary care hospital in North India for 4 years between 2019 and 2022. The study included all cases diagnosed with UBPGL on histopathology and confirmed on immunohistochemistry. Results: Nine study cases were included in this study with a median age of 56 years. Most cases had a history of palpitations, hematuria, and hypertension. Tissue specimens for all the cases were obtained after transurethral resection of bladder tumors. Histologically, the zellballen pattern was present in seven (78.8%), and a diffuse growth pattern was present in two (22.2%) cases. Delicate fibrovascular stroma was pronounced in eight (88.9%) cases. Immunohistochemically, all nine tumors were positive for chromogranin A and eight were positive for synaptophysin. Muscularis propria invasion was seen in seven (78.8%) cases, a focal sheet-like pattern in one (11.1%), a ribbon-like growth pattern in one (11.1%), focal necrosis in three (33.3%), and associated significant cautery artifacts in four cases (44.5%). Conclusions: UBPGL is often misdiagnosed as urothelial cancer because of its frequent muscle invasion and similar morphology. Distinguishing paraganglioma from urothelial cancer is vital because of the difference in prognosis and surgical management. A conclusive diagnosis can be made with thorough histologic examination and immunohistochemical analysis.
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spelling doaj-art-fb7116ee19b341d984d10a92a4bf691e2025-08-20T02:26:24ZengWolters Kluwer Medknow PublicationsArchives of Medicine and Health Sciences2321-48482321-60852024-12-0112332332810.4103/amhs.amhs_282_23A Gamut of Astounding Diagnosis as Paraganglioma of Urinary Bladder: A Retrospective Study from North IndiaNazia Manzoor WalvirAiffa AimanInara AbeerMohammad Iqbal LoneShadab MaqsoodBackground and Aim: Urinary bladder paraganglioma (UBPGL) is a rare neuroendocrine neoplasm, accounting for <0.05% of all bladder tumors and 0.7% of all paragangliomas. This study aimed to describe the histopathology of UBPGL, emphasizing the histologic attributes that may help pathologists recognize this rare bladder tumor and aid in differentiation from urothelial malignancies and other tumors that may resemble paragangliomas. Materials and Methods: This retrospective observational study was conducted in the pathology department of a tertiary care hospital in North India for 4 years between 2019 and 2022. The study included all cases diagnosed with UBPGL on histopathology and confirmed on immunohistochemistry. Results: Nine study cases were included in this study with a median age of 56 years. Most cases had a history of palpitations, hematuria, and hypertension. Tissue specimens for all the cases were obtained after transurethral resection of bladder tumors. Histologically, the zellballen pattern was present in seven (78.8%), and a diffuse growth pattern was present in two (22.2%) cases. Delicate fibrovascular stroma was pronounced in eight (88.9%) cases. Immunohistochemically, all nine tumors were positive for chromogranin A and eight were positive for synaptophysin. Muscularis propria invasion was seen in seven (78.8%) cases, a focal sheet-like pattern in one (11.1%), a ribbon-like growth pattern in one (11.1%), focal necrosis in three (33.3%), and associated significant cautery artifacts in four cases (44.5%). Conclusions: UBPGL is often misdiagnosed as urothelial cancer because of its frequent muscle invasion and similar morphology. Distinguishing paraganglioma from urothelial cancer is vital because of the difference in prognosis and surgical management. A conclusive diagnosis can be made with thorough histologic examination and immunohistochemical analysis.https://journals.lww.com/10.4103/amhs.amhs_282_23gangliocyticneuroendocrineparagangliomaurinary bladderurothelial
spellingShingle Nazia Manzoor Walvir
Aiffa Aiman
Inara Abeer
Mohammad Iqbal Lone
Shadab Maqsood
A Gamut of Astounding Diagnosis as Paraganglioma of Urinary Bladder: A Retrospective Study from North India
Archives of Medicine and Health Sciences
gangliocytic
neuroendocrine
paraganglioma
urinary bladder
urothelial
title A Gamut of Astounding Diagnosis as Paraganglioma of Urinary Bladder: A Retrospective Study from North India
title_full A Gamut of Astounding Diagnosis as Paraganglioma of Urinary Bladder: A Retrospective Study from North India
title_fullStr A Gamut of Astounding Diagnosis as Paraganglioma of Urinary Bladder: A Retrospective Study from North India
title_full_unstemmed A Gamut of Astounding Diagnosis as Paraganglioma of Urinary Bladder: A Retrospective Study from North India
title_short A Gamut of Astounding Diagnosis as Paraganglioma of Urinary Bladder: A Retrospective Study from North India
title_sort gamut of astounding diagnosis as paraganglioma of urinary bladder a retrospective study from north india
topic gangliocytic
neuroendocrine
paraganglioma
urinary bladder
urothelial
url https://journals.lww.com/10.4103/amhs.amhs_282_23
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