The significance of colonic mucosa (intestinal metaplasia) involving the urinary tract

Although colonic type goblet cells are a relatively common component of reactive urothelial lesions and well-differentiated adenocarcinomas, complete replacement of areas of urothelium by benign appearing intestinal mucosa is a rare condition. All of the 11 documented cases occurred in association with abnormalities leading to chronic irritation and/or infection. In the three cases where the reported period of observation exceeded 2 years, all patients developed carcinoma. Despite its innocuous histology, widespread intestinal metaplasia apparently identifies a disturbed urothelium at high risk for cancer.