Suspicion of malignancy was raised by the imaging findings and cystoscopy with biopsy was recommended. Cystoscopic guided biopsy of the lesion showed it to be cystitis glandularis with intestinal metaplasia. The lesion was limited to lamina propria. No atypia / mucous extravasation seen.

Cystitis glandularis (CG) is a proliferative disorder of the urinary bladder in which there is glandular metaplasia of the transitional cells lining the urinary bladder. It is not an uncommon condition and often identified on biopsies and cystectomies. It usually occurs in the trigone of the urinary bladder. 

The intestinal subtype of CG has been proposed to be a precursor of adenocarcinoma. However, certain authors have considered CG to be a chronic and quiescent histologic lesion without any clinical significance.