Ureteritis cystica- a rare urological condition
Ivan Neretljak¹, Janko Orešković¹, Anita Šktrić², Ika Kardum Skelin³, Lovro Kavur⁴, Mario Sučić¹
¹Department of Urology, ²Department of pathology, ³Department of cytology, ⁴Department of radiology; KB Merkur, Zagreb
Introduction
Ureteritis cystica is a rare benign condition that affects ureter and renal pelvis. The etiology of the disease is not known, but it is associated with chronic urothelial irritation that can be caused by nephrolithiasis and urinary tract infections.
Case report
A 70 years old female patient was addmited in office due to left upper back pain. The patient passed two ipsilateral kidney stones 2 and 3 years ago. Urin analysis and blood work were within normal limits. Ultrasound showed no kidney stones and no dilatation of renal pelvis. CT scan was performed and it showed multiple irregular filling defects in the ureter and left renal pelvis.
Explorative cystoureteroscopy was performed. The urinary bladder was found to be normal. In proximal part of left ureter and in left renal pelvis multiple yellow cystic lesions were seen. Cysts were punctured and milky and cloudy fluid was drained from cysts. Material was collected for cytological evaluation and its wall was collected for pahtological evaluation. Pathologist and cytologist confirmed the diagnosis.
Discussion
Ureteritis cystica is a rare benign condition.
A differential diagnosis of multiple transitional cell tumors, ureteral pseudodiverticula, nonopaque calculi, polyps, papillary tumors, vascular impressions can be considered with an appropriate clinical correlation.
Histologically there are numerous small submucosal epithelial-lined cysts representing cystic degeneration of metaplastic epithelium or submucosal Brunn cell nests.
Conclusion
Ureteritis cystica should be considered as differential diagnosis in atypical radilogical findings. When confirmed no active treatment is required.