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Cleva M, Ennio B, Ferdinando B, Massimo V. Eosinophilic cystitis: a case report of a pseudotumoral lesion. J Ultrasound 2023; 26:935-937. [PMID: 37589872 PMCID: PMC10632338 DOI: 10.1007/s40477-023-00816-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/22/2023] [Indexed: 08/18/2023] Open
Abstract
Eosinophilic cystitis is a rare inflammatory disorder of the bladder, characterized by eosinophilic infiltration of the bladder wall, fibrosis of the mucosa, and muscle necrosis. Ultrasonography, when performed, shows a pseudotumoral mass that can be mistaken for malignancy. We report a case of a woman referred to our department in which an ultrasound showed a bladder mass and the biopsy demonstrated the presence of eosinophilic cystitis. The patient was treated with medical treatment and the outcome was favorable with the disappearance of symptoms and no recurrence at controls. We carry a literature review of cystitis eosinophilic, the ultrasound appearance, and therapeutic modalities.
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Affiliation(s)
- Mirco Cleva
- Radiological Department, Sant'Antonio Abate Hospital ASUFC, Via Giobatta Morgagni, 20, 33028, Tolmezzo, UD, Italy.
| | - Bruschi Ennio
- Radiological Department, Sant'Antonio Abate Hospital ASUFC, Via Giobatta Morgagni, 20, 33028, Tolmezzo, UD, Italy
| | | | - Valentino Massimo
- Radiological Department, Sant'Antonio Abate Hospital ASUFC, Via Giobatta Morgagni, 20, 33028, Tolmezzo, UD, Italy
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Hasan A, Abdel-Al I, Nafie K, Rashad MF, Abozied H, Elhussiny ME, Rabie A, Rabaan AA, Abd Elnabi MK, Abdelwahed MS, Ahmed MA, Mohammed Y. Clinicopathological characteristics and outcomes of eosinophilic cystitis: A retrospective study. Ann Med Surg (Lond) 2021; 68:102626. [PMID: 34386222 PMCID: PMC8346616 DOI: 10.1016/j.amsu.2021.102626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 07/26/2021] [Accepted: 07/26/2021] [Indexed: 11/20/2022] Open
Abstract
Background Eosinophilic cystitis (EC) is a rare inflammatory urinary bladder disorder whose etiology, pathogenesis, and treatment are unknown. The work aims to evaluate the clinical manifestations, cystoscopic characteristics, pathological features, treatment, and clinical outcome of EC patients. Materials and methods The clinical records and histopathology material of 22 patients diagnosed as EC during ten years were reviewed and analyzed for patient's age, sex, clinical data, cystoscopic features, biopsy procedures, treatment plan, follow-up, and prognosis. Frequencies, normality tests, descriptive statistics, and correlations were run. Results The mean age of patients was 46.5 + 17 years, 12 females and 10 males. Regarding the patient's complaints, dysuria was the most frequent main symptom, followed by hematuria. On cystoscopic examination, bladder mass was seen in 54.5% of patients. Six patients (27.3%) were associated with different allergic diseases; however peripheral eosinophilia was shown in two patients (9.1%). All cases revealed predominance of eosinophilic infiltration on microscopic examination. The most commonly used medications were corticosteroids for 72.7% of patients with tapering dose giving a significant improvement with a recorded recurrence in one patient after 12 months from the first lesion. Conclusions No specific clinical presentation for EC patients and histopathology is the standard diagnostic tool. Medical treatment including corticosteroids was the first line with good prognosis, although recurrence remains a possibility which emphasizes the importance of patients’ follow-up. Eosinophilic cystitis is a rare inflammatory disorder of the bladder. Etiology, pathogenesis, and treatment are unknown. A total of 22 patients were retrospectively studied and analyzed. Histopathological examination is standard tool for diagnosis. Oral steroids gave a significant improvement.
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Affiliation(s)
- Abdulkarim Hasan
- Department of Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Laboratory & Blood Bank Department, Prince Mishari Bin Saud Hospital, Baljurashi, Saudi Arabia
- Corresponding author. Department of Pathology, Faculty of Medicine, Al-Azhar University, 11884Cairo, Egypt.
| | - Ibrahim Abdel-Al
- Department of Urology, Faculty of Medicine, Al-Azhar University, Assiut Branch, Egypt
| | - Khalid Nafie
- Laboratory & Blood Bank Department, Prince Mishari Bin Saud Hospital, Baljurashi, Saudi Arabia
| | - Mahmoud F. Rashad
- Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hesham Abozied
- Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | | | - Ahmed Rabie
- Department of Pathology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Manar K. Abd Elnabi
- Biofuels Institute, School of the Environment and Safety Engineering, Jiangsu University, Zhenjiang, China
- Botany Department, Faculty of Science, Tanta University, Tanta, Egypt
| | - Mohammed S. Abdelwahed
- Department of Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Department of Pathology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Mohammed A. Ahmed
- Department of Pathology, Faculty of Medicine, Al-Azhar University, Assiut Branch, Egypt
| | - Yasien Mohammed
- Department of Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Duong DT, Goodman HS. Eosinophilic cystitis caused by Candida glabrata: A case report. Urol Case Rep 2019; 26:100970. [PMID: 31380221 PMCID: PMC6661408 DOI: 10.1016/j.eucr.2019.100970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/16/2019] [Indexed: 11/12/2022] Open
Abstract
Eosinophilic cystitis is a rare disease of the bladder, for which there is no clear cause or standard treatment. We report the case of a 61 year old man who presented with irritative voiding symptoms and gross hematuria. Cystoscopy showed diffuse urothelial erythema and a posterior bladder wall ulcer. Bladder biopsy revealed marked eosinophilic cystitis with ulceration. Urine culture grew Candida glabrata. After treatment with oral fluconazole, his voiding symptoms resolved and subsequent bladder biopsy revealed a complete dearth of eosinophils. This is the first case report linking eosinophilic cystitis to Candida glabrata.
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Affiliation(s)
- David T Duong
- Urology Associates, P.C., 2801 Charlotte Avenue, Nashville, TN, 37209, USA
| | - Harris S Goodman
- Saint Francis Memorial Hospital, 900 Hyde Street, San Francisco, CA, 94109, USA
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Chaker K, Bouzouita A, Gharbi M, Blel A, Chakroun M, Ayed H, Cherif M, Ben Slama MR, Rammeh S, Derouiche A, Chebil M. [Diagnosis and treatment of eosinophilic cystitis]. Pan Afr Med J 2019; 31:45. [PMID: 30918571 PMCID: PMC6430843 DOI: 10.11604/pamj.2018.31.45.16149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 08/06/2018] [Indexed: 11/19/2022] Open
Abstract
La cystite à éosinophiles est une pathologie inflammatoire de la paroi vésicale. Elle est rare, il n'existe pas des recommandations établies concernant sa prise en charge. Il s'agit d'une étude rétrospective ayant concerné dix observations de cystites à éosinophiles diagnostiquées et prises en charge dans notre service entre 2006 et 2017. L'âge moyen des patients était de 46 ans. On a noté une prédominance masculine. Un terrain atopique était noté dans 3 cas. Le mode de présentation le plus fréquent était des signes urinaires irritatifs dans 9 cas, une hématurie macroscopique dans 8 cas et des algies pelviennes dans 6 cas. Une hyper-éosinophilie sanguine était présente dans 4 cas. La cystoscopie avait montré des pétéchies dans 5 cas, un aspect pseudo-tumoral dans 4 cas et était normal dans un cas. Pour les formes pseudo-tumorales une résection endoscopique a été pratiquée. Quatre patients ont été traités par les anti-inflammatoires non stéroïdien, avec amélioration des symptômes. Six malades ont été surveillés. Après un recul moyen de 50 mois, aucune récidive n'a été rapportée. La cystite à éosinophiles est une pathologie rare. La présentation clinique est non spécifique. La prise en charge repose sur des moyens médicaux non invasifs dans les formes peu symptomatiques.
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Affiliation(s)
- Kays Chaker
- Service d'Urologie, Hôpital Charles Nicole, Tunis, Tunisie
| | | | - Marwa Gharbi
- Service d'Urologie, Hôpital Charles Nicole, Tunis, Tunisie
| | - Ahlem Blel
- Service d'Anatomie Pathologique, Hôpital Charles Nicole, Tunis, Tunisie
| | | | - Haroun Ayed
- Service d'Urologie, Hôpital Charles Nicole, Tunis, Tunisie
| | - Mohamed Cherif
- Service d'Urologie, Hôpital Charles Nicole, Tunis, Tunisie
| | | | - Soumaya Rammeh
- Service d'Anatomie Pathologique, Hôpital Charles Nicole, Tunis, Tunisie
| | | | - Mohamed Chebil
- Service d'Urologie, Hôpital Charles Nicole, Tunis, Tunisie
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Abstract
The aim of the present case report was to investigate the clinical features, pathological examination and treatment of eosinophilic cystitis (EC) in children. Two cases of EC were reported and reviewed from January 2016 to March 2017. Case 1 (male; 6 years old) had intermittent hematuria, frequent urination, urgent urination, difficulty in urination and abdominal pain. Case 2 (male; 7 years old) had frequent urination, urgent urination, urinary pain, dysuria and suprapubic pain with no hematuria. One patient had a history of allergies and both patients underwent a cystoscope biopsy. Blood eosinophils were clearly increased and a bone marrow biopsy examination revealed that marrow eosinophils were also increased in both cases. The urine culture results were negative. Ultrasonography and computed tomography revealed uneven thickening of the bladder wall and diffusive mucosal lesions. Cystoscopy revealed that the bladder volume became smaller and the mucosa at the bladder floor and neck was red. Lesions were biopsied through the urethra and the following characteristics were observed: Congestion and edema of the bladder mucosa, infiltration of the blood vessels and eosinophils in the muscular layer, accompanied by focal muscle necrosis. Patient 1 was administered anti-inflammatory and cetirizine hydrochloride treatments, followed by 6 weeks of prednisone dose-reduction therapy. Patient 2 was administered antibiotics and cetirizine hydrochloride. Following 6-month follow-ups, abnormal voiding symptoms had disappeared in each case. Ultrasonography and computed tomography revealed no bladder wall thickening or space-occupying lesions. EC in children is rare and easily misdiagnosed as nonspecific bladder inflammation or bladder occupying lesions. Cystoscopy and biopsy are necessary to diagnose EC and conservative treatments with anti-inflammatory, anti-allergic and cortical hormone nonspecific treatments are suggested.
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Abstract
Eosinophilic cystitis is a rare inflammatory disease of the bladder whose origin, pathogenesis, and treatment are unknown. Frequency, dysuria, and hematuria are frequent symptoms. Here, we report a rare occurrence of recurrent urinary retention and repetitive catheterization. A 67-year-old male presented with acute urinary retention and intermittent gross hematuria of 2 weeks duration. Urethral catheterization followed by a trial without catheter, was successful. Complete blood count showed presence of eosinophils (eosinophilia) and computed tomography of kidneys, ureter and bladder with contrast showed thickened bladder wall and small prostate. Cystoscopy revealed an erythematous lesion over the anterior wall. The rest of the mucosa was normal. Transurethral biopsies of the lesion were performed and histologic examination showed features of eosinophilic cystitis. Despite multiple medication regimens containing corticosteroids and antihistamines, he presented with recurrent urinary retention, approximately once every month. After 6 months, he was started on bethanechol, which led to no catheterization for up to 2 years. To the best of our knowledge, this is the first report on the successful use of bethanechol as a treatment for eosinophilic cystitis with recurrent urinary retention.
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Affiliation(s)
- Hongzoo Park
- Department of Urology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea
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