Ketamine cystitis as a mimic of carcinoma in situ

Histopathology. 2009 Dec;55(6):705-8. doi: 10.1111/j.1365-2559.2009.03437.x.

Abstract

Aims: To describe the histopathological features of a series of patients with ketamine-related cystitis.

Methods and results: Seventeen patients with ketamine-related cystitis, who had undergone biopsy, were identified and reviewed. Twelve showed ulceration with significant urothelial atypia. In 10 of these, immunohistochemistry was performed; 9/10 had high p53 immunoreactivity and 7/10 had moderate to high levels of Ki67 reactivity, but all were negative for cytokeratin 20.

Conclusions: Ketamine can lead to reactive urothelial changes that can mimic carcinoma in situ, but the long-term cancer risk remains unknown.

MeSH terms

  • Adult
  • Biomarkers, Tumor / metabolism
  • Carcinoma / diagnosis*
  • Carcinoma / metabolism
  • Cystitis / chemically induced*
  • Cystitis / diagnosis*
  • Cystitis / metabolism
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunohistochemistry
  • Ketamine / adverse effects*
  • Male
  • Urinary Bladder / metabolism
  • Urinary Bladder / pathology*
  • Urinary Bladder Neoplasms / diagnosis*
  • Urinary Bladder Neoplasms / metabolism
  • Urothelium / metabolism
  • Urothelium / pathology

Substances

  • Biomarkers, Tumor
  • Ketamine