Xanthogranulomatous Ureteritis: A Diagnostic Challenge in a Patient with Bladder Cancer

Int J Surg Pathol. 2024 Feb;32(1):182-186. doi: 10.1177/10668969231169049. Epub 2023 May 4.

Abstract

Xanthogranulomatous ureteritis is a very rare process characterized by the presence of foamy histiocytes in a background of chronic active inflammation affecting the ureteral wall. Herein, we describe a case of a 64-year-old man with bladder cancer affecting the left posterolateral wall of the bladder. Radiologically, there was a suspicion of multifocal involvement of the ureteral wall. The patient underwent a radical cystectomy with bilateral pelvic lymphadenectomy and a laparoscopic left nephroureterectomy. Histopathologic examination of the radical cystectomy revealed an invasive high-grade urothelial carcinoma. The wall of the left ureter was replaced by abundant foamy histocytes and a mixed inflammatory infiltrate with lymphocytes and plasma cells consistent with xanthogranulomatous ureteritis. In this report, we highlight the importance of awareness of this benign process when observing a ureteral mass in cancer patients.

Keywords: bladder cancer; inflammation; ureter; xanthogranulomatous ureteritis.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Transitional Cell* / diagnosis
  • Carcinoma, Transitional Cell* / pathology
  • Carcinoma, Transitional Cell* / surgery
  • Gastrointestinal Diseases* / pathology
  • Granuloma / pathology
  • Humans
  • Inflammation / pathology
  • Male
  • Middle Aged
  • Plasma Cells / pathology
  • Ureter* / pathology
  • Ureter* / surgery
  • Urinary Bladder Neoplasms* / complications
  • Urinary Bladder Neoplasms* / diagnosis
  • Urinary Bladder Neoplasms* / surgery
  • Urinary Tract Infections* / pathology