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Bladder
Cystitis
Eosinophilic cystitis
Author: Nat Pernick, M.D. (see Authors page)
Revised: 20 December 2009, UPDATE IN PROGRESS
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Definition
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● Difficult to recognize as a distinctive entity because large numbers of eosinophils are associated with numerous bladder diseases and post-surgery
Terminology
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Epidemiology
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● Rare
● Women or children with allergic disorders and peripheral eosinophilia, older men with prostate/bladder disorders (AJCP 1979;72:777) or parasitic infestation; also idiopathic
Sites
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Etiology
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● Hypothesis is that an antigen-antibody response occurs in the bladder and attracts eosinophils, which provoke an inflammatory response.
Clinical features
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● Recurrent episodes of dysuria and hematuria
● Clinical and imaging findings are nonspecific (Arch Pathol Lab Med 2009;133:289)
● Not related to Langerhans cell granulomatosis
● In children, symptoms tend to disappear spontaneously (Arch Dis Child 2001;84:344)
Prognostic factors
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Case reports
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Treatment
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● Typically has a benign, self-limiting course following removal of the etiologic factor, if known
● Local transurethral resection can be supplemented by antihistamines, steroids, nonsteroidal anti-inflammatory drugs or antibiotics if there is infection (Radiographics 2006;26:1847)
● Some patients may require cystectomy for severe, unremitting symptoms (J Urol 2001;165:805)
● Frequent recurrence (Eur Urol 2000;37:386)
● Long term followup is advised (Int J Clin Pract 2005;59:356)
Clinical images
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Intraoperative photo shows mass protruding into lumen, link
Gross description (Macroscopy)
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● Edematous and erythematous mucosa with polypoid growths resembling allergic polyps of nasal septum
Gross images
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Circumferentially thickened bladder wall, link
Micro description (Histopathology)
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● Chronic inflammatory infiltrate with marked eosinophils; also fibrosis, muscle necrosis, variable giant cells (Archives 1984;108:728)
Micro images
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Eosinophilic cystitis due to schistosomiasis (egg not visible)
Post-cord blood stem cell transplant for AMML, link
Intense infiltration of eosinophils deep within the muscularis propria, link
Cytology description
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Cytology images
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Positive stains
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Negative stains
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Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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● (link to topic)
Additional references
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End of Bladder > Cystitis > Eosinophilic cystitis
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