Course Map: Tumor-like Lesions: Schistosomiasis

Schistosomiasis
Aside from the association with bladder cancer, schistosomiasis can also produce inflammatory polyps, ulcerations, and tumor-like excrescences which will cystoscopically resemble carcinoma. All of this is secondary to the deposition of schistosomal ova in the lamina propria and muscularis propria followed by an acute inflammatory reaction (neutrophils and/or eosinophils) and then by formation of discrete granulomas. Eventually there is calcification and fibrosis of the bladder wall. Imaging studies will detect calcific deposits and variable filling defects [96].
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	Figure 1: Schistosomiasis.
	Figure 2: Adult schistosome in outer bladder wall.
	Figure 3: Calcified ova in lamina propria producing chronic and polypoid cystitis.
	Figure 4: Calcified ova associated with multiple discrete granulomas. Proliferative cystitis is seen at the surface.