Bladder, ureter & renal pelvis
Cystitis
Granulomatous cystitis
Author: Monika Roychowdhury, M.D.
Topic Completed: 1 April 2011
Minor changes: 19 July 2020
Copyright: 2003-2019, PathologyOutlines.com, Inc.
PubMed Search: bladder[title] granulomatous cystitis
Table of Contents
Definition / general | Etiology | Clinical features | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) imagesCite this page: Roychowdhury M. Granulomatous cystitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bladdergranulomatouscystitis.html. Accessed August 7th, 2020.
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
- Primary vesical actinomycosis (Int J Urol 2007;14:969)
Treatment
- Possibly bladder botulinum toxin A injection to increase bladder capacity (BJU Int 2008;102:704)
Gross description
- Can present as mass/polypoid lesion
Microscopic (histologic) description
- Tuberculosis: caseating granulomas with Langhans 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
Microscopic (histologic) images
Images hosted on other servers:
Due to bCG treatment
Postresection
