Stipple sign (transitional cell carcinoma)

The stipple sign refers to the pointillistic end-on appearance on intravenous pyelography or retrograde pyelography of contrast material tracking into the interstices of a papillary lesion. Because the majority of transitional cell carcinomas (TCC) have a papillary configuration, the presence of this sign should raise the suspicion of TCC. While the stipple sign is best seen in large papillary bladder tumors, it can occur anywhere a urothelial tumor expresses papillary architecture.

Be aware, however, that the stipple sign may also be seen with blood clots and fungus balls, and is not pathognomonic for TCC.

Article information

rID: 2089
Section: Signs
Synonyms or Alternate Spellings:

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Cases and figures

  • Pointillistic technique : "Grande Jatte" by G Seurat
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