Surgical Pathology Criteria–

Fibroepithelial Polyp of the Urinary Tract

Differential Diagnosis

Papillary / Polypoid Cystitis Fibroepithelial Polyp
Papillae and polyps arise diffusely directly from the bladder wall Polypoid mass from which papillae and projections arise
Generalized/diffuse process Solitary lesion in most cases
Generalized inflammation even in late stages Inflammation not prominent
These two may not always be separable; both are benign

Papillary Urothelial Neoplasms Fibroepithelial Polyp
Delicate papillary stalks Broad, fibrous base and stalks
Lining may be atypical Lined by normal urothelium

Nephrogenic Adenoma Fibroepithelial Polyp
Lined by single layer of cells, frequently hobnailed Lined by normal multilayered transitional epithelium
No umbrella cells Normal umbrella cells present
Usually associated with tubular submucosal component Submucosal component if present is cystitis cystica/glandularis

Florid Cystitis Cystica and/or Glandularis NOS Fibroepithelial Polyp (some FEP contain focal or extensive cystitis cystica/glandularis)
Does not form a distinct polyp Well formed, distinct polyp with bulbous, lobulated shape
Multiple or diffuse lesions Solitary lesion, adjacent bladder normal

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