Korean J Urol.  2009 Mar;50(3):296-299.

Paraganglioma of a Bladder with a Bladder Stone

• Lee KS
• Kim JD
• Kim KH
• Seo YJ
• Lee JI
• Lee YS
• Kim SW

Abstract

Paragangliomas of the urinary bladder are very rare tumors of the paraganglion system that arise from chromaffin cells in or near the sympathetic ganglia. Only approximately 15% of them develop from extra-adrenal chromaffin tissue. Most of these tumors are hormonally active and secrete mainly noradrenaline (rarely adrenaline), calcitonin, and adrenocorticotropic hormone. Paragangliomas are generally benign tumors, with less than 10% being malignant. Here we report a case of a paraganglioma arising in a urinary bladder with a bladder stone.

Keyword

Paraganglioma; Urinary bladder; Urinary bladder calculi

MeSH Terms

Adrenocorticotropic Hormone
Calcitonin
Chromaffin Cells
Ganglia, Sympathetic
Norepinephrine
Paraganglioma
Urinary Bladder
Urinary Bladder Calculi
Adrenocorticotropic Hormone
Calcitonin
Norepinephrine

Figure

• 

  Fig. 1 Pelvic CT scan showing a 2×2 cm sized calcification in the posterior wall of the bladder.

• 

  Fig. 2 Microscopic features of the tumor. The tumor was composed of nests of cuboidal epithelial cells surrounding a delicate vasculature. Tumor cells are characterized by relatively uniform round nuclei with fine chromatin and abundant amphophilic cytoplasm (H&E, ×200).

• 

  Fig. 3 Immunohistochemical stain for CD56. Tumor cells reveal a diffuse strong positive reaction to CD56 (×400).

• 

  Fig. 4 Tumor infiltrates into the proper muscular layer (arrow)(H&E, ×100).

Reference

1. Siatelis A, Konstantinidis C, Volanis D, Leontara V, Thoma-Tsagli E, Delakas D. Pheochromocytoma of the urinary bladder: report of 2 cases and review of literature. Minerva Urol Nefrol. 2008. 60:137–140.

2. Zimmerman IJ, Biron RE, MacMahon HE. Pheochromocytoma of the urinary bladder. N Engl J Med. 1953. 249:25–26.

3. Seon IC, Kang SH, Kwak KM, Chung WK, Lee YS, Han CH, et al. Paraganglioma of the bladder. Korean J Urol. 2003. 44:198–200.

4. Whalen RK, Althausen AF, Daniels GH. Extra-adrenal pheochromocytoma. J Urol. 1992. 147:1–10.

5. Asbury WL Jr, Hatcher PA, Gould HR, Reeves WA, Wilson DD. Bladder pheochromocytoma with ring calcification. Abdom Imaging. 1996. 21:275–277.

6. Onishi T, Sakata Y, Yonemura S, Sugimura Y. Pheochromocytoma of the urinary bladder without typical symptoms. Int J Urol. 2003. 10:398–400.

7. Demirkesen O, Cetinel B, Yaycioglu O, Uygun N, Solok V. Usual cause of early preeclampsia: bladder paraganglioma. Urology. 2000. 56:154.

8. Liu Y, Dong SG, Dong Z, Mao X, Shi XY. Diagnostic and treatment of pheochromocytoma in urinary bladder. J Zhejiang Univ Sci B. 2007. 8:435–438.

9. Grignon DJ, Ro JY, Mackay B, Ordonez NG, el-Naggar A, Molina TJ, et al. Paraganglioma of the urinary bladder: immunohistochemical, ultrastructural, and DNA flow cytometric studies. Hum Pathol. 1991. 22:1162–1169.

10. Singh DV, Seth A, Gupta NP, Kumar M. Calcified nonfunctional paraganglioma of the urinary bladder mistaken as bladder calculus: a diagnostic pitfall. BJU Int. 2000. 85:1152–1153.