Bladder - Chronic cystitis

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Bladder

Cystitis

Chronic cystitis

Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 29 June 2011, last major update June 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Definition
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● Chronic inflammatory cell infiltrate of lamina propria, due to recurrent or prolonged urinary tract infections

Terminology
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● Includes follicular cystitis

Epidemiology
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● More common in women, most likely because urethra is shorter

Etiology
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● Typically due to repeated bouts of urinary tract infection
● In some females, may be due to altered bladder mucosal responses to gram negative bacteria, caused by delayed initiation of antibiotic therapy after acute gram negative infections (PLoS Pathog 2010;6:ii:e1001042)

Treatment
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● Ovestin intravaginal cream (estriol) may reduce recurrences (Urologiia 2009 Jul-Aug;(4):14)

Gross description
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● Heaping of mucosa
● Red, friable, ulcerated mucosa

Micro description
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● Chronic inflammatory cell infiltrate
● Fibrous thickening of muscularis propria
● Often reactive epithelial atypia
● Note: florid chronic cystitis may mask urothelial carcinoma

Micro images
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With keratinizing squamous metaplasia

Cytology description
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● Nuclei are enlarged with prominent nucleoli
● Variable cytoplasmic vacuoles

Differential diagnosis
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● MALT lymphoma: forms solitary or multiple masses; monoclonal

End of Bladder > Cystitis > Chronic cystitis

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