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One month later, repeat cystoscopy and MRI showed complete resolution. The case emphasizes CGD-related reactive or inflammatory changes that can mimic neoplasia and the need for cautious interpretation with short-interval reassessment.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/bladder-masses-simulating-neoplasia-in-chronic-granulomatous-disease-diagnostic-challenges-and-spontaneous-regression/407438/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/bladder-masses-simulating-neoplasia-in-chronic-granulomatous-disease-diagnostic-challenges-and-spontaneous-regression/407438.png","ImageObject",300,407,{"name":42,"@type":43},"Mia 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papillary masses.",{"name":70,"@type":61,"acceptedAnswer":71},"How did the lesions evolve after the initial biopsy?",{"text":72,"@type":64},"Despite initial histopathologic findings compatible with PUNLMP, repeat cystoscopy and MRI one month later demonstrated complete resolution of all previously visualized bladder masses.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},407438,1790719034,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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Reports  \njournal [homepage:](homepage: www.elsevier.com/locate/eucr)[ www.elsevier.com/locate/eucr](homepage: www.elsevier.com/locate/eucr)  \n| Inflammation and infection\u003Cbr>Bladder masses simulating neoplasia in chronic granulomatous disease: Diagnostic challenges and spontaneous regression |  |  | |\n| --- | --- | --- | --- |\n| Mehdi Dadpour a,* , Niloofar Soleimanifardb, Sobhan Alishaha, Miaad Chalakia\u003Cbr>a Department of Urology, Shahid Labbafinejad Medical Center, The Center of Excellence in Urology, Urology and Nephrology Research Center, Research Institute for Urology and Nephrology, Shahid Beheshti University of Medical Sciences, Tehran, Iran\u003Cbr>b Department of Urology, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran |  |  |  |\n| A R T I C L E I N F O |  | A B S T R A C T |  |\n| Keywords:\u003Cbr>Chronic granulomatous disease\u003Cbr>Bladder neoplasm\u003Cbr>Hematuria\u003Cbr>Biopsy |  | Chronic granulomatous disease (CGD) rarely involves the lower urinary tract, and bladder mass–like lesions are exceptionally uncommon. We report a 23-year-old male with CGD who presented with gross hematuria and multiple large papillary bladder masses on imaging and cystoscopy. Cold-cup biopsies suggested papillary urothelial proliferation but were inconclusive due to limited sampling. Remarkably, repeat cystoscopy and MRI one month later showed complete resolution of all lesions. This case highlights the potential for CGD-related reactive or inflammatory changes to mimic neoplasia and emphasizes the importance of cautious interpretation and short-interval reassessment in such patients. |  |\n\n1. Introduction  \nChronic granulomatous disease (CGD) is a rare primary immunodeficiency marked by impaired phagocytic function, predisposing patients to recurrent infections and granuloma formation across multiple organ systems.1 While gastrointestinal and respiratory involvement are well documented, urological manifestations are uncommon and usually arise from obstructive processes caused by granulomatous inflammation.2 The occurrence of bladder masses in individuals with CGD is exceptionally rare, and lesions with a neoplastic appearance present notable diagnostic challenge, particularly in young adults.3  \nPapillary urothelial tumors, including papillary urothelial neoplasm of low malignant potential (PUNLMP), are seldom seen in this age group, making their presence in an immunocompromised patient even more unexpected. Moreover, distinguishing true neoplastic changes from reactive or inflammatory mimics in CGD is often difficult, especially when biopsy specimens are limited.4,5  \nWe describe a rare case of a young male with CGD who developed multiple bladder masses resembling urothelial neoplasia, which completely regressed within one month, underscoring important diagnostic and clinical considerations.  \n2. Case presentation  \nA 23-year-old male with a known history of chronic granulomatous disease (CGD) since childhood—initially presenting with granulomatous lesions of the buccal mucosa and axillary region—had been maintained on itraconazole, cotrimoxazole prophylaxis, and interferon-gamma injections.  \nHe presented to our urology clinic with a four-month history of gross hematuria. Ultrasonography of the urinary tract demonstrated multiple large bladder masses with irregular margins (Fig. 1). Following multidisciplinary discussion and clearance from the immunology team, diagnostic cystoscopy with possible biopsy was performed.  \nCystoscopy evaluation (Fig. 2) revealed numerous large, papillary masses diffusely distributed across the bladder mucosa. Because of the extensive involvement and the impracticality of complete resection, representative biopsies were obtained.  \nHistopathological examination demonstrated papillary urothelial proliferation with mild cytologic atypia, findings compatible with papillary urotheli","cbCaiffghMRcRife","https://ap.wps.com/l/cbCaiffghMRcRife","pdf",5432897,"English","# Introduction\n## Case presentation\n## Diagnostic workup and initial findings\n## Follow-up and spontaneous regression","[{\"question\":\"Why are bladder masses in chronic granulomatous disease (CGD) diagnostically challenging?\",\"answer\":\"CGD-related reactive or inflammatory changes can mimic true neoplasia, and limited biopsy sampling may make it difficult to distinguish reactive urothelial proliferation from papillary urothelial neoplasm.\"},{\"question\":\"What clinical presentation and imaging findings were reported in the case?\",\"answer\":\"The patient had four months of gross hematuria, and ultrasonography showed multiple large bladder masses with irregular margins, with cystoscopy revealing numerous diffusely distributed papillary masses.\"},{\"question\":\"How did the lesions evolve after the initial biopsy?\",\"answer\":\"Despite initial histopathologic findings compatible with PUNLMP, repeat cystoscopy and MRI one month later demonstrated complete resolution of all previously visualized bladder masses.\"}]","Bladder masses simulating neoplasia in chronic granulomatous disease - Diagnostic challenges and spontaneous regression | PDF",1790573923]