Ketamine cystitis as a mimic of carcinoma in situ


Dr J Oxley, BSc, MD, FRCPath, Department of Cellular Pathology, North Bristol NHS Trust, Southmead Hospital, Westbury on Trym, Bristol BS10 5NB, UK. e-mail:


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.