Bladder
Cystitis
Granulomatous cystitis

Author: Monika Roychowdhury, M.D. (see Authors page)

Revised: 31 March 2016, last major update April 2011

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: bladder[title] granulomatous cystitis
Definition / General
  • Granulomas in bladder, due to various infectious or treatment related causes
Etiology
  • Tuberculosis, bCG (bacillus Calmette-Guerin) treatment for papillary urothelial carcinoma, biopsy / resection, Schistosoma haematobium infection, actinomycosis
Clinical Features
  • 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
Case Reports
Treatment
Gross Description
  • Can present as mass/polypoid lesion
Micro Description
  • 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 (Am J Clin Pathol 1993;99:244)
  • Post-biopsy / resection: either necrotizing and palisading, resembling rheumatoid nodules, or foreign body type (without foreign material) or both (Am J Clin Pathol 1986;86:430)
  • Actinomycosis: scattered lymphoid follicles and non-specific inflammation with or without intermixed colonies of Actinomyces
Micro Images

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Due to bCG treatment

Post-resection