Urinary Bladder Biopsy with Denuded Mucosa: Denuding Cystitis-Cytopathologic Correlates

Anil V. Parwani, Angelique W. Levi, Jonathan I. Epstein, Syed Z. Ali

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Denuding cystitis is often encountered in tissue biopsies of bladder mucosa performed by either cold-cup forceps or wire loop electrocautery to evaluate hematuria or to rule out recurrent urothelial carcinoma. Lack of urothelium in these biopsies is often a frustrating experience, leading to a nonspecific interpretation. In this study, 151 cases of denuding cystitis were retrieved from the surgical pathology files of The Johns Hopkins Hospital over a 4-year period (1996-1999). Patients under the age of 40 years and outside consultation material were excluded. Of the 151 cases of denuding cystitis, 48 patients were identified who had concurrent urinary cytologic studies. Of these patients, 35 were male (73%) and 13 were female (27%). Patient ages ranged from 43 to 85 years (mean, 67). Twenty-six of these 48 patients (54%) had at least one concurrently positive urinary cytology, which was histologically confirmed. All except three cases were high-grade urothelial carcinoma with the following histologic subtypes: flat carcinoma in situ (n = 11), noninvasive papillary (n = 9), and invasive urothelial carcinoma (n = 3). We conclude that urinary cytology is a sensitive modality that detects exfoliated carcinoma cells in patients with a histologic diagnosis of denuding cystitis. An inconclusive diagnosis of denuding cystitis on tissue might be related to biopsy method and technique, small sample size, or biopsy of cystoscopically abnormal urothelium that is denuded. A cytologic diagnosis of high-grade urothelial carcinoma in these cases leads to a timely clinical intervention for optimal patient management.

Original languageEnglish (US)
Pages (from-to)297-300
Number of pages4
JournalDiagnostic cytopathology
Issue number5
StatePublished - May 2004


  • Denuding cystitis
  • Urinary bladder
  • Urinary cytology
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology


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