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Bladder
Cystitis
Granulomatous cystitis
Author: Nat Pernick, M.D. (see Authors page)
Revised: 25 December 2009, last major update - December 2009
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Definition
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● Granulomas in bladder, due to tuberculosis, bCG, post-biopsy/resection, actinomycosis (Int J Urol 2007;14:969)
Terminology
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Epidemiology
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Sites
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Etiology
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● Tuberculosis, bCG (bacillus Calmette-Guerin) treatment for papillary urothelial carcinoma or prior biopsy / resection
Clinical features
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Tuberculosis: rare in most countries; bladder lesions near trigone, smaller lesions merge over time into large ulcers; may involve prostate or vagina; often secondary infection from kidney
bCG: used to treat high grade papillary carcinoma or carcinoma in situ of bladder
Post-biopsy / resection: present in 14% with 2 surgical procedures
Prognostic factors
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Case reports
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Treatment
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● Possibly bladder botulinum toxin A injection to increase bladder capacity (BJU Int 2008;102:704)
Clinical images
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Gross description (Macroscopy)
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Gross images
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Micro description (Histopathology)
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● Tuberculosis: caseating granulomas with Langerhans giant cells, mostly in lamina propria with mucosal ulceration
● bCG: induces chronic inflammation, superficial ulceration and noncaseating granulomas with active and chronic inflammation; changes may extend into prostate (AJCP 1993;99:244)
Post-biopsy / resection: either necrotizing and palisading, resembling rheumatoid nodules, or foreign body type (without foreign material) or both (AJCP 1986;86:430)
Micro images
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Micro images: due to bCG treatment
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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Additional references
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End of Bladder > Cystitis > Granulomatous cystitis
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