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Postoperative Spindle Cell Nodule Pathology

Definition

Postoperative spindle cell nodules (PSCNs) are benign, localized, reactive lesions
 usually described as histologically identical to inflammatory myofibroblastic tumors (IMTs), except that a history of instrumentation or trauma to the bladder (eg, core needle biopsy, surgery) can be elicited (see the image below).
 PSCNs are polypoid or nodular and involve any portion of the bladder wall, most commonly the dome.

Postoperative spindle cell nodule of the bladder,

Postoperative spindle cell nodule of the bladder, with muscularis propria on the left.

Males are affected more commonly than females, with a male-to-female ratio ranging from 2:1
 to 3:1.
 The first large series of 38 cases comprised patients aged 2.5 months to 87 years.
The mean patient age was 65 years.

Hematuria is the most common presenting symptom, present in most patients, followed by bladder outlet obstruction and dysuria.

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