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Bladder

Cystitis

Xanthogranulomatous cystitis

Reviewers: Turki Al-Hussain, M.D., Johns Hopkins Medical Centers (see Reviewers page)
Revised: 24 March 2011, last major update March 2011
Copyright: (c) 2003-2010, PathologyOutlines.com, Inc.

Definition
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● Rare (<50 cases reported in bladder) inflammatory disorder characterized by lipid-laden macrophages

Clinical features
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● Benign, but associated with malignancy in some cases (Histopathology 1998;33:212)
● Associated with xanthogranulomatous pyelonephritis, urachal adenomas, inflammatory bowel disease

Case reports
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● 50 year old man with multiple small polypoidal growths (Int Urol Nephrol 2007;39:477)
● 76 year old man with painless hematuria and bladder mass (Int Urogynecol J Pelvic Floor Dysfunct 2007;18:1233)

Treatment
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● Broad spectrum antibiotics; possibly resection

Micro description
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● Lipid-laden macrophages, plasma cells and lymphocytes
● May have some Touton-type giant cells
● Similar to malakoplakia but without Michaelis-Gutmann bodies

Micro images
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Lamina propria contains sheets of lipid-laden macrophages


Xanthogranulomatous pyelonephritis

Positive stains
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● CD68 (macrophages), CD163

Negative stains
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● Cytokeratin

Differential diagnosis
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● Malakoplakia: has Michaelis-Gutmann bodies
● Urothelial carcinoma: cytokeratin positive

End of Bladder > Cystitis > Xanthogranulomatous cystitis

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