24 Single or Multiple Filling Defects in the Urinary Bladder

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GU 24-1 Bladder calculi. (A) Excretory urogram demonstrates a large stone (arrows) in a left-sided bladder diverticulum. (B) Plain radiograph of the pelvis shows the laminated stone and multiple smaller calculi that were obscured by contrast material in the right-sided bladder diverticula on the contrast-filled view.

• Fig GU 24-2 Transitional cell carcinoma. (A) Large, irregular filling defect (arrows) in the bladder. (B) In another patient, the irregular tumor (open arrows) is associated with a large filling defect (closed arrows), representing benign prostatic hypertrophy, at the base of the bladder.

• Fig GU 24-3 Benign prostatic hypertrophy. Large, smooth filling defect at the base of the bladder. Note the fishhook appearance of the distal ureters and the calcification in the vas deferens.

Fig GU 24-4 Carcinoma of the prostate. Elevation of and markedly irregular impression on the floor of the contrast-filled bladder.

• Fig GU 24-5 Bilateral simple ureteroceles.

Fig GU 24-6 Endometriosis. Right posterior oblique view of the bladder shows an irregular, rounded filling defect along the posterior dome.24

• Fig GU 24-7 Cystitis. Irregular, lobulated filling defects (representing intense mucosal edema) at the base of the bladder.

Fig GU 24-8 Emphysematous cystitis. Plain film of the pelvis shows radiolucent gas in the wall of the bladder.7

Fig GU 24-9 Cystitis cystica and cystititis glandularis. Oblique view shows a nodular filling defect (arrow) in a lobulated bladder.24

Fig GU 24-10 Malacoplakia. Postvoiding excretory urogram shows multiple smooth, nodular filling defects.18