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Nasrallah OG, Balaghi A, El Sayegh N, Mahdi JH, Sinno S, Nasr RW. Florid Cystitis Glandularis with Intestinal Metaplasia in the Prostatic Urethra: a case report and review of the literature. Int J Surg Case Rep 2024; 116:109416. [PMID: 38422750 PMCID: PMC10943984 DOI: 10.1016/j.ijscr.2024.109416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Cystitis glandularis is a proliferative disease of the bladder epithelium usually presenting in the setting of chronic inflammation, characterized by the formation of glands in the bladder mucosa and submucosa. Intestinal metaplasia is a described process in cystitis glandularis characterized by the presence of intestinal cells and mucin production which is rare as compared to cystitis glandularis. CASE PRESENTATION We present a case of cystitis glandularis with intestinal metaplasia located in the bladder and concomitantly in the prostatic urethra. Patient underwent transurethral resection of the lesion which was unusually found in the prostatic urethra. CLINICAL DISCUSSION Florid cystitis glandularis is a rare condition found in women more than in men. It usually presents with irritative lower urinary tract symptoms or hematuria which leads to its eventual diagnosis. It is usually causes by inflammation to the bladder mucosa due to infections or irritation. Patients are diagnosed through Transurethral resection of these bladder lesions found in the trigone and bladder neck region. Surgery is the standard treatment of choice. However, medical treatment may also be used to treat underlying inflammatory conditions using antibiotics, steroids, and non-steroidal anti-inflammatory agents. Radical or partial cystectomy may be performed for severe refractory cases. CONCLUSION This article describes the rare occurrence of florid cystitis glandularis in the prostatic urethra and provides an overview on diagnosis, etiology, and management of the disease.
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Affiliation(s)
- Oussama G Nasrallah
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Alaa Balaghi
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Noura El Sayegh
- Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jana H Mahdi
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Sara Sinno
- Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rami W Nasr
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
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Jeon J, Ha JS, Shin SJ, Ham WS, Choi YD, Cho KS. Differences in clinical features between focal and extensive types of cystitis glandularis in patients without a previous history of urinary tract malignancy. Investig Clin Urol 2023; 64:597-605. [PMID: 37932571 PMCID: PMC10630690 DOI: 10.4111/icu.20230210] [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: 06/21/2023] [Revised: 07/31/2023] [Accepted: 08/16/2023] [Indexed: 11/08/2023] Open
Abstract
PURPOSE To understand the clinical differences of cystitis glandularis (CG), a proliferative disorder of urinary bladder epithelium, based on the extent of cystoscopic findings in patients without a history of urinary tract malignancy. MATERIALS AND METHODS We conducted a review of patients diagnosed with CG in two tertiary hospitals from 2005 to 2021. Patients with previous or concurrent history of urinary tract malignancy were excluded. Medical records, including demographics, endoscopic and all available imaging studies, and managements, were reviewed. Patients were divided into two types according to extent of the lesion, and their clinical features were compared. RESULTS In total, 110 patients were enrolled in the final analysis, with 36 (32.7%) classified as extensive type and 74 (67.3%) as focal type. Patients with extensive type were predominantly males and relatively younger than those with focal type (p=0.025). Voiding problems were more strongly associated and hydronephrosis caused by CG was significantly more common in the extensive type (p=0.005 and p=0.003, respectively). Multiple transurethral resection procedures were more frequently performed in the extensive type (p=0.017). Subsequent urinary tract malignancy was observed in four patients, all of whom had focal-type CG. CONCLUSIONS There were significant differences in clinical features between the extensive- and focal-types CG. The extensive type was more often associated with urologic complications. Meanwhile, in the focal type, subsequent urinary tract malignancy might develop during the follow-up period. Thus, thorough initial work-up and careful follow-up is necessary despite the benign nature of CG. Annual surveillance cystoscopy may be appropriate.
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Affiliation(s)
- Jinhyung Jeon
- Department of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Soo Ha
- Department of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Su-Jin Shin
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Won Sik Ham
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young Deuk Choi
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Kang Su Cho
- Department of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul, Korea.
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Kusumaputra A, Rahman IA, Wirjopranoto S. Severe obstructive symptoms and urinary bladder mass due to cystitis glandularis: A very rare case report in children. Int J Surg Case Rep 2022; 100:107709. [PMID: 36244150 PMCID: PMC9574407 DOI: 10.1016/j.ijscr.2022.107709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/25/2022] [Accepted: 09/25/2022] [Indexed: 11/29/2022] Open
Abstract
Cystitis Glandularis (CG) is an unusual proliferative disease of the bladder. This condition was associated with chronic inflammation or chronic obstruction. This condition usually presents as microscopic finding and the presence of large macroscopic lesion is a rare feature. Until now, the course of disease from transitional to cystitis glandularis is still unclear and the uncertainty of CG to potentially develop into adenocarcinoma has once been documented. Herewith, we report our experience with 2 years old boy with cystitis glandularis presenting with LUTS obstructive symptoms, hematuria and bladder mass. Ultrasound examination revealed bilateral hydronephrosis with hydroureter and bladder wall thickness suggesting the sign of obstruction and chronic inflammation. Cystoscopy examination was performed to ensure the diagnosis with the result revealing protruding mass partially obstructing the bladder trigone, both ureteral orifice and posterior urethra. Transurethral resection was performed and the administration of COX-2 inhibitor and oral steroid therapy were given. Post-operative course was uneventful with the improvement in symptom and uroflowmetry revealed promising result. This case represented an entity of rare and interesting case of cystitis glandularis causing severe obstructive symptoms and urinary bladder mass which appropriate therapy of endoscopic intervention, COX-2 inhibitor and oral steroid resulted in promising outcome. Follow up of 1 year resulted in reduced LUTS symptoms such as straining and difficulty of urination. Cystitis Glandularis (CG) is an unusual proliferative disease of the bladder This condition is associated with inflammation or chronic obstruction Manifestation of large visible macroscopic lesion of the urinary bladder is an extremely rare entity Appropriate therapy consisted of endoscopic intervention, COX-2 inhibitor and oral steroid for Cystitis Glandularis resulted in promising outcome.
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Affiliation(s)
- Ahmad Kusumaputra
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
| | - Ilham Akbar Rahman
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
| | - Soetojo Wirjopranoto
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia.
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Ahmad A, Imbisat MZ, Ranjan N, Tiwari RK, Kumar B, Khatoon Q. Cystitis glandularis- rare cause of urinary bladder mass: case report and literature review. AFRICAN JOURNAL OF UROLOGY 2022. [DOI: 10.1186/s12301-022-00279-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cystitis glandularis a rare benign proliferative disease of the urinary bladder mucosa is usually a microscopic finding and manifests rarely as a large visible macroscopic lesion of urinary bladder. Only few cases of cystitis glandularis presenting as urinary bladder mass in female patients have been reported in the literature. We are reporting a case of cystitis glandularis presenting as a urinary bladder mass in a very young female patient.
Case presentation.
Our patient, a young female 25 years of age presented in the Urology OPD with complaints of irritative lower urinary tract symptoms for two years and intermittent hematuria for one year. On evaluation, she was found to have a urinary bladder mass. Transurethral resection of her urinary bladder mass was done and on histopathological examination, it came out to be cystitis glandularis.
Conclusion
Clinical presentation of cystitis glandularis is variable. It may remain asymptomatic or could present as irritative lower urinary tract symptoms, hematuria, or mucus in the urine. It is normally a microscopic finding but could also present as an overt urinary bladder mass however this has been reported rarely in the literature.
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Bhana K, Lazarus J, Kesner K, John J. Florid cystitis cystica et glandularis causing irreversible renal injury. Ther Adv Urol 2021; 13:17562872211022465. [PMID: 34178117 PMCID: PMC8202316 DOI: 10.1177/17562872211022465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/13/2021] [Indexed: 11/25/2022] Open
Abstract
Cystitis cystica et glandularis (CCEG) is widely believed to be innocuous and self-limiting. We report a case of a 32-year-old male patient who was found to have gross bilateral hydroureter and hydronephrosis and an estimated glomerular filtration rate of 3 ml/min/1.73 m2. Cystoscopy revealed extensive cystic and nodular lesions involving most of the bladder urothelium, which proved to be CCEG on histopathological analysis. Retrograde and anterograde stents could not be inserted due to obstruction of the ureters at the level of the vesicoureteric junction. Percutaneous nephrostomies were subsequently inserted. Although there was evidence of improvement of the CCEG on follow-up cystoscopy, no improvement of renal function, despite decompression with percutaneous nephrostomies, was seen. He was subsequently placed on the waiting list for a renal transplant. We believe this to be the only known case reported of florid CCEG obstructing the upper urinary tracts bilaterally, causing irreversible renal injury.
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Affiliation(s)
- Kerisha Bhana
- Division of Urology, Department of Surgery, Frere Hospital and Walter Sisulu University, East London, South Africa
| | - John Lazarus
- Division of Urology, Department of Surgery, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Ken Kesner
- Division of Urology, Department of Surgery, Frere Hospital and Walter Sisulu University, East London, South Africa
| | - Jeff John
- Department of Urology, Department of Surgery, Frere Hospital and Walter Sisulu University, East London 5200, South Africa
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Karaosmanoglu AD, Uysal A, Karcaaltincaba M, Akata D, Ozmen MN, Kraeft J, Hahn PF. Imaging findings of infectious and inflammatory diseases of the urinary system mimicking neoplastic diseases. Abdom Radiol (NY) 2020; 45:1110-1121. [PMID: 31570959 DOI: 10.1007/s00261-019-02222-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Neoplastic diseases affecting the urinary organs are common, and diagnosis by imaging is usually straightforward. However, infectious/inflammatory processes also commonly affect these organs and can be mistaken for a neoplasm. Familiarity with these potential mimickers and awareness of their imaging presentations are key for correct diagnosis. We present the imaging findings of non-neoplastic infectious/inflammatory diseases that can mimic a neoplastic process.
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Affiliation(s)
| | - Aycan Uysal
- Department of Radiology, Gulhane Training and Research Hospital, 06010, Ankara, Turkey
| | | | - Deniz Akata
- Department of Radiology, Hacettepe University School of Medicine, 06100, Ankara, Turkey
| | - Mustafa Nasuh Ozmen
- Department of Radiology, Hacettepe University School of Medicine, 06100, Ankara, Turkey
| | - Jessica Kraeft
- Department of Radiology, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Peter F Hahn
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA.
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Yuksel OH, Urkmez A, Erdogru T, Verit A. The role of steroid treatment in intractable cystitis glandularis: A case report and literature review. Can Urol Assoc J 2015; 9:E306-9. [PMID: 26029302 DOI: 10.5489/cuaj.2636] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Cystitis glandularis is a proliferative disease of the urinary bladder epithelium. It is rare in children. We report a case of a 23-year-old female with intractable macroscopic hematuria and severe irritative bladder symptoms persisting for 13 years. The patient, who had undergone open and endoscopic bladder surgery at various medical centres, is currently being followed up at our clinic. Cystoscopy revealed multiple edematous papillary tumours on the bladder neck, trigone, and lateral wall on both sides and she underwent transurethral resection of the bladder tumour. The pathological diagnosis was cystitis glandularis in accordance with the histopathological reports obtained from the other medical centres. Her condition was resistant to transurethral resection, partial cystectomy, intravesical mitomycin, and bacillus Calmette-Guerin (BCG) treatment; it eventually could have affected the upper urinary tract. Oral steroid treatment was given for 6 months; after treatment, her symptoms improved and the cystoscopy revealed a dramatic improvement in her condition.
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Affiliation(s)
- Ozgur Haki Yuksel
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Ahmet Urkmez
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Tibet Erdogru
- Department of Urology, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Ayhan Verit
- Department of Urology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
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Lu Q, Jiang F, Xu R, Zhao XK, Zhong ZH, Zhang L, Jiang HY, Yi L, Hou Y, Zhu X. A pilot study on intravesical administration of curcumin for cystitis glandularis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:269745. [PMID: 23762117 PMCID: PMC3674727 DOI: 10.1155/2013/269745] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Revised: 03/20/2013] [Accepted: 04/09/2013] [Indexed: 12/11/2022]
Abstract
Cystitis glandularis (CG) is a proliferative disorder in the urinary bladder. The outcome of current treatments in some patients is not satisfactory. Curcumin, a herbal medicine that has been used for centuries, has shown great potential in treating various diseases. Our pilot study aimed to explore the feasibility of an intravesical treatment for CG using curcumin. 14 patients diagnosed with CG that remained symptomatic after primary treatments were enrolled, underwent a 3-month curcumin intravesical treatment (50 mg/50 mL, 1 hour, once per week for first 4 weeks and once per month for next 2 months) and were followed up for 3 months. Efficacy of the treatment was evaluated using core lower urinary tract symptom score (CLSS) questionnaire. 10 patients demonstrated persistent improvement in symptoms up to the end of the 6-month study. Their CLSS decreased significantly after the 3-month treatment (6.0 ± 0.8; P < 0.01) from the baseline (10.5 ± 1.6) and maintained decreasing till the end of the study (6.2 ± 0.7; P < 0.01). 4 patients were classified as nonresponders. Our study suggests the feasibility of further randomized controlled trials on curcumin intravesical treatment in CG patients who remain symptomatic after primary treatments.
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Affiliation(s)
- Qiong Lu
- Department of Pharmacy, Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Fen Jiang
- Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, Busan 614-735, Republic of Korea
| | - Ran Xu
- Department of Urology, Second Xiangya Hospital of Central South University, No. 139 Renminzhonglu-Road, Furong-District, Changsha 410011, China
| | - Xiao-Kun Zhao
- Department of Urology, Second Xiangya Hospital of Central South University, No. 139 Renminzhonglu-Road, Furong-District, Changsha 410011, China
| | - Zhao-Hui Zhong
- Department of Urology, Second Xiangya Hospital of Central South University, No. 139 Renminzhonglu-Road, Furong-District, Changsha 410011, China
| | - Lei Zhang
- Department of Urology, Second Xiangya Hospital of Central South University, No. 139 Renminzhonglu-Road, Furong-District, Changsha 410011, China
| | - Hong-Yi Jiang
- Department of Urology, Second Xiangya Hospital of Central South University, No. 139 Renminzhonglu-Road, Furong-District, Changsha 410011, China
| | - Lu Yi
- Department of Urology, Second Xiangya Hospital of Central South University, No. 139 Renminzhonglu-Road, Furong-District, Changsha 410011, China
| | - Yi Hou
- Department of Urology, Second Xiangya Hospital of Central South University, No. 139 Renminzhonglu-Road, Furong-District, Changsha 410011, China
| | - Xuan Zhu
- Department of Urology, Second Xiangya Hospital of Central South University, No. 139 Renminzhonglu-Road, Furong-District, Changsha 410011, China
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Michajłowski J, Matuszewski M, Kłącz J, Gibas A, Biernat W, Krajka K. Acute urinary retention in a patient with extended cystitis glandularis. Cent European J Urol 2011; 64:94-6. [PMID: 24578874 PMCID: PMC3921714 DOI: 10.5173/ceju.2011.02.art11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2011] [Revised: 02/25/2011] [Accepted: 03/15/2011] [Indexed: 11/22/2022] Open
Abstract
Cystitis glandularis (CG) is defined as glandular metaplasia of bladder urothelium. In most cases the course of CG is asymptomatic. However, some patients complain of hematuria and lower urinary tract symptoms (LUTS) of varying degrees. We present a case of 45-year-old man with an extensive CG causing acute urinary retention. Although it was initially treated as an infection, prompt ultrasound and cystoscopy helped to establish the diagnosis. Transurethral resection of the cyst with biopsy of the bladder mucosa was then performed. Immediately after surgery the patient noticed significant improvement in urine passing. During the 2-month follow-up there was no relapse.
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Affiliation(s)
| | | | - Jakub Kłącz
- Department of Urology, Medical University of Gdańsk, Poland
| | - Artur Gibas
- Department of Urology, Medical University of Gdańsk, Poland
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Horiuchi K, Ohgaki K, Sato M, Oka F, Nishimura T. A case of asymptomatic cystitis glandularis found incidentally with ultrasonography at a private clinic. J NIPPON MED SCH 2009; 75:347-9. [PMID: 19155573 DOI: 10.1272/jnms.75.347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A 46-year-old man was transferred to our hospital because of a bladder mass. The mass could not be distinguished from a primary bladder tumor or a tumor invading from another organ with computed tomography, magnetic resonance, or cystoscopic examination. Transurethral resection of the mass was performed, and the pathological diagnosis was typical cystitis glandularis. The patient has been followed up with cytologic examination and ultrasonography, and after 10 months there has been no new growth of the mass or malignant change.
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Affiliation(s)
- Kazutaka Horiuchi
- Department of Urologic Surgery, Graduate School of Medicine Nippon Medical School, Tokyo, Japan.
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Coelho RF, Marchini GS, Dall’Oglio MF, de Medeiros MT, Nesrallah AJ, Srougi M. Cystoprostatectomy with ileal neobladder for treatment of severe cystitis glandularis in an AIDS patient. Clinics (Sao Paulo) 2008; 63:713-6. [PMID: 18925335 PMCID: PMC2664733 DOI: 10.1590/s1807-59322008000500023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Rafael Ferreira Coelho
- Department of Urology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo – São Paulo/SP, Brazil
| | - Giovanni Scala Marchini
- Department of General Surgery, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo – São Paulo/SP, Brazil
| | - Marcos Francisco Dall’Oglio
- Department of Urology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo – São Paulo/SP, Brazil
| | - Mabel Tatty de Medeiros
- Department of Pathology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo – São Paulo/SP, Brazil. Phone: 55 11 9450.2824,
| | - Adriano João Nesrallah
- Department of Urology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo – São Paulo/SP, Brazil
| | - Miguel Srougi
- Department of Urology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo – São Paulo/SP, Brazil
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Touffahi M, Fredj N, Lefi M, Hafsa C, Hallara W, Moussa A, Saad H. [To analyse diagnosis, management and prognosis of florid cystitis glandularis (pseudoneoplastic entity)]. Prog Urol 2008; 17:968-72. [PMID: 17969799 DOI: 10.1016/s1166-7087(07)92399-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To analyse diagnosis, management and prognosis of florid cystitis glandularis (pseudoneplastic entity). PATIENTS AND METHODS A retrospective study of 6 consecutive patients with florid cystitis glandularis seen at the department of Urology of Monastir (Tunisia) from January 1996 to July 2006. All patients underwent ultrasonography, and cystoscopy. Computed tomography (CT) was performed in four patients and magnetic resonance imaging (MRI) in one patient. RESULTS The six patients, all of whom were male, ranged from 22 to 68 (average 42) years of age. The most common complaints was haematuria. Radiological examination and cystoscopy suggested a bladder tumor in all patients. Histopathology revealed features of cystitis glandularis of intestinal type. Features of the pelvic CT and MRI were consistent with the diagnosis of pelvic lipomatosis in one patient. The endoscopic resection was performed in 5 patients. Recurrence occurred in one of these 5 patients within one and 7 years of follow-up. The other patient had developed a low compliance small-capacity bladder and bilateral ureteral obstruction. A total cystoprostatectomy and ileal neobladder construction was considered, but it was declined by the patient. The patient was treated with anti-inflammatory drug (Indometacine 100 mg/day). CONCLUSION Cystitis glandularis may be mistaken for bladder tumor The diagnosis is histological. Treatment is based on eradication of the irritative factors and endoscopic resection of the tumoral masses. The clinical course is unclear, requiring long-term fellow-up.
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Affiliation(s)
- Mounir Touffahi
- Service d'urologie CHU Fattouma Bourguiba Monastir, Tunisie.
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Semins MJ, Schoenberg MP. A case of florid cystitis glandularis. ACTA ACUST UNITED AC 2007; 4:341-5. [PMID: 17551538 DOI: 10.1038/ncpuro0814] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Accepted: 04/17/2007] [Indexed: 11/09/2022]
Abstract
BACKGROUND A 32-year-old healthy woman from China was diagnosed with a bladder mass during pelvic ultrasonography, carried out during the work-up of a miscarriage. Cystoscopy by the Department of Obstetrics and Gynecology confirmed the presence of a bladder mass, after which she was referred to our department for evaluation and management. The patient was asymptomatic at presentation. She denied urologic symptoms and did not have a history of smoking or industrial exposure to carcinogens. INVESTIGATIONS Laboratory test results and urine studies were unremarkable. Cytology revealed benign cells with numerous micro-organisms. Intravenous pyelography revealed a 1 x 2 cm filling defect in the mid posterior bladder compatible with a mass. There were no upper urinary tract defects. We performed cystoscopy with transurethral resection of the bladder tumor. DIAGNOSIS Pathology revealed cystitis glandularis. MANAGEMENT The patient was followed up with repeat cystoscopy after 4 months; there was no evidence of recurrence. She was scheduled for surveillance after a further 3 months, but was lost to follow-up.
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Affiliation(s)
- Michelle Jo Semins
- James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
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Kaya C, Akpinar IN, Aker F, Turkeri LN. Large Cystitis Glandularis: A Very Rare cause of Severe Obstructive Urinary Symptoms in an Adult. Int Urol Nephrol 2006; 39:441-4. [PMID: 17171414 DOI: 10.1007/s11255-006-9042-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2006] [Accepted: 05/09/2006] [Indexed: 10/23/2022]
Abstract
Cystitis glandularis is a very rare proliferative disorder of the mucus-producing glands within the mucosa and submucosa of urinary bladder epithelium. We report such a case of glandular cystitis with intestinal metaplasia masquerading as a bladder tumor in a young male patient who presented with severe obstructive urinary symptoms. Cystoscopy revealed a tumor well circumscribed, measuring 5 x 4 cm on the trigone. Transurethral resection of the mass was carried out and the histopathology suggested cystitis glandularis. The literature regarding this entity has been reviewed and the differential diagnosis was discussed. Short-term follow-up of the patient with sonography and cystoscopy showed no recurrence.
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Affiliation(s)
- Cevdet Kaya
- Department of Urology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
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