Bladder, ureter & renal pelvis


Granulomatous cystitis

Last author update: 1 April 2011
Last staff update: 1 November 2021

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PubMed Search: bladder[title] granulomatous cystitis

Monika Roychowdhury, M.D.
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Cite this page: Roychowdhury M. Granulomatous cystitis. website. Accessed December 6th, 2022.
Definition / general
  • Granulomas in bladder, due to various infectious or treatment related causes
  • 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
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

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Due to bCG treatment


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