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Bladder
Cystitis
Interstitial (Hunner’s) 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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● Rare idiopathic condition of edematous and possibly ulcerated bladder mucosa
● Diagnosis of exclusion
● Diagnose from clinical features since histologic features are nonspecific (Am J Surg Pathol 1990;14:969)
Terminology
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● Also called Hunner’s ulcer, painful bladder syndrome
Epidemiology
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● Middle-aged white women
Sites
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Etiology
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● Associated with shift from the normal bladder urothelial keratin phenotype to a more squamous keratin profile, although is no morphologic evidence of squamous differentiation (Am J Clin Pathol 2006;125:105)
Clinical features
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● Suprapubic pain related to bladder filling, accompanied by increased frequency and other symptoms, with no urinary infection or other obvious pathology
● Best diagnosed from clinical features, since histologic findings are nonspecific (AJSP 1990;14:969)
Prognostic factors
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Case reports
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Treatment
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Variable; includes behavioral modification, pharmacotherapy or endoscopic
treatments
Clinical images
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Gross description (Macroscopy)
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Gross images
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No thumbnail: chronic interstitial cystitis
Micro description (Histopathology)
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● May have normal histology
● May have mucosal ulceration with overlying fibrinous exudates and necrotic debris
● Lamina propria contains chronic inflammatory cells, prominent mast cells and fibrosis
● Usually no bacteria identified
Micro images
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Fig B: edema and inflammatory cells in bladder mucosa
No thumbnail: Interstitial cystitis #1; #2; #3
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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● National Institutes of Health, Wikipedia, eMedicine
End of Bladder > Cystitis > Interstitial (Hunner’s) cystitis
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