Bladder, ureter & renal pelvis


Eosinophilic cystitis

Last author update: 1 April 2011
Last staff update: 29 October 2021

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PubMed Search: Bladder[title] eosinophilic cystitis

Monika Roychowdhury, M.D.
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Cite this page: Roychowdhury M. Eosinophilic cystitis. website. Accessed September 28th, 2023.
Definition / general
  • Inflammatory condition of the urinary bladder, with recurrent episodes of urinary frequency, dysuria, gross hematuria and suprapubic pain during micturition
  • Not related to Langerhans cell granulomatosis
  • Rare (about 200 reported cases)
  • Women or children with allergic disorders and peripheral eosinophilia, older men with prostate / bladder disorders or parasitic infestation
Clinical features
  • Reported at all ages with striking predominance in females
  • 20% occur in children; symptoms tend to disappear spontaneously (Arch Dis Child 2001;84:344)
  • Clinical and imaging findings are nonspecific; cystoscopic findings include ulcers, exudates, edematous bullae or polyps (which may simuate malignancy)
Case reports
  • Treatments are typically not curative
  • Withdrawal of any identifiable precipitating factor
  • Nonsteroidal antiinflammatory agents and antihistamines are favored first line agents followed by corticosteroids or cyclosporine
  • Transurethral resection is used in refractory cases (J Urol 2001;165:805)
  • Longterm followup is recommended for all patients (Int J Clin Pract 2005;59:356)
Clinical images

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Mass (arrow) protruding into the lumen

Gross description
  • Edematous and erythematous mucosa with polypoid growths resembling allergic polyps of nasal septum
Microscopic (histologic) description
  • Hispathological findgings can be divided in "acute" and "chronic" phase:
  • Acute phase: prominent eosinophilic infiltrate (Yamada and Taguchi criteria are 20 or more eosinophils per five 20x fields) with edema and occasional muscle necrosis; Charcot-Leyden crystals may be present (Arch Pathol Lab Med 2009;133:289)
  • Chronic phase: fewer eosinophils but more prominent mast cells, plasma cells and muscle fibrosis
Microscopic (histologic) images

Contributed by Jian-Hua Qiao, M.D.
Inflammatory infiltrate with marked eosinophils

Inflammatory infiltrate with marked eosinophils

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