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Dawman L, Peters NJ, Tiewsoh K, Bal A, Sodhi K, Samujh R. Bladder Mass Masquerading as Eosinophilic Cystitis in a Child: When to Think Beyond Malignancy? J Indian Assoc Pediatr Surg 2021; 26:51-53. [PMID: 33953514 PMCID: PMC8074822 DOI: 10.4103/jiaps.jiaps_36_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/04/2020] [Accepted: 04/26/2020] [Indexed: 11/09/2022] Open
Abstract
Eosinophilic cystitis is a rare inflammatory disease in the pediatric population with varied presentations. Diagnosis requires a high index of suspicion and cystoscopy with biopsy of the bladder mass. There are no standard treatment guidelines, however, these patients usually respond with medical management, but recurrence is a possibility. We present a case of eosinophilic cystitis in a 6-year-old boy who presented with lower urinary tract symptoms, gross hematuria, and bladder mass.
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Affiliation(s)
- Lesa Dawman
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nitin James Peters
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Karalanglin Tiewsoh
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Amanjeet Bal
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kushaljit Sodhi
- Department of Radiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ram Samujh
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Al Sbihi AF, Manasrah N, Al Qasem S, Abdelhady M, Shi D. Gross Hematuria in an Elderly Smoker Male Due to Eosinophilic Cystitis. Cureus 2020; 12:e12400. [PMID: 33532159 PMCID: PMC7847224 DOI: 10.7759/cureus.12400] [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] [Indexed: 11/21/2022] Open
Abstract
This is a case of a 71-year-old smoker man who presented with four days of gross hematuria, which turned to be caused by eosinophilic cystitis (EC) proven by bladder biopsy. EC is a rare clinical and pathological inflammatory condition of the bladder with an unknown exact cause. It can present with hematuria, urinary frequency, dysuria, and suprapubic pain. Sometimes, the presentation can mimic urinary tract infection (UTI) or malignancy, especially in older patients.
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Affiliation(s)
- Ali F Al Sbihi
- Internal Medicine, Detroit Medical Center Sinai Grace Hospital, Detroit, USA
| | - Nouraldeen Manasrah
- Internal Medicine, Detroit Medical Center Sinai Grace Hospital, Detroit, USA
| | | | - Mazen Abdelhady
- Urology, Detroit Medical Center Sinai Grace Hospital, Detroit, USA
| | - Dongping Shi
- Pathology, Detroit Medical Center Sinai Grace Hospital, Detroit, USA
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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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Chia D. Eosinophilic cystitis and haematuria: Case report of a rare disease and common presentation. Int J Surg Case Rep 2016; 24:43-5. [PMID: 27179336 PMCID: PMC4873027 DOI: 10.1016/j.ijscr.2016.04.055] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/27/2016] [Accepted: 04/30/2016] [Indexed: 11/25/2022] Open
Abstract
Eosinophilic cystitis is a disease of unknown aetiology, however there is an association with a history of allergies and atopy. Common presentations are urinary frequency, dysuria, haematuria, and suprapubic pain, leading to diagnosis of less sinister urinary causes such as urinary tract infections. Natural history is difficult to predict, varying from acute self-resolving cases to chronic debilitating conditions requiring hospital admissions and radical interventions. It is difficult to distinguish from other forms of cystitis and biopsy is necessary for diagnosis. Treatment can vary from medical to operative intervention, or a combination of both.
Introduction Eosinophilic cystitis is a rare inflammatory condition of the bladder that can cause haematuria. The aetiology is unknown and clinical presentation is difficult to distinguish from other causes of haematuria. Diagnosis is confirmed by biopsy. In this case, a patient with haematuria is diagnosed with eosinohpilic cystitis after presenting to hospital. He was commenced on antibiotics for a presumed urinary tract infection with no resolution of haematuria and symptoms. After diagnosis he was commenced on treatment with resolution of symptoms. Case presentation A 73-year-old male presents with first episode of haematuria. He was initially diagnosed with a urinary tract infection and commenced on antibiotics with no resolution. After further investigations including a cystoscopy and bladder biopsy, he was diagnosed with eosinophilic cystitis. He was treated with steroids improving his symptoms. Conclusion Eosinophilic cystitis is a rare disease of the bladder which is difficult to distinguish from other causes of haematuria, and is often misdiagnosed. Bladder biopsy is necessary for diagnosis. Early diagnosis is important, and it is through a combination of non-operative and operative interventions such as biopsy. Natural history is difficult to predict as it is difficult to determine is a patient will have a benign course with resolution with or without treatment, or result in a chronic course which may result in bladder damage and renal failure. This case highlights the importance of investigating haematuria that is unresponsive to initial empiric treatment such as antibiotics. It is important to refer to a Urologist for further investigation to rule out a sinister cause, but to also obtain a diagnosis, leading to definitive treatment.
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Affiliation(s)
- Daniel Chia
- Department of Urology, Westmead Hospital, Corner of Hawkesbury Road and Darcy Road, Westmead, Sydney, NSW, 2145, Australia.
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Dinary B, Shaheen K, Eisa N, Alraies MC, Alraiyes AH, Ravakhah K. Hypereosinophilic syndrome induced cystitis mimicking bladder tumor. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2013; 5:331-3. [PMID: 23814766 PMCID: PMC3690792 DOI: 10.4103/1947-2714.112488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Buthayna Dinary
- Department of Medicine, Case Western Reserve University/St. Vincent Charity Medical Center, Cleveland, USA
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Eosinophilic cystitis: a rare cause of hematuria in children. Case Rep Nephrol 2012; 2012:710230. [PMID: 24558612 PMCID: PMC3914238 DOI: 10.1155/2012/710230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 11/13/2012] [Indexed: 11/17/2022] Open
Abstract
A 7-year-old boy presented with a history of acute onset of hematuria, dysuria, and suprapubic pain. Urine routine and microscopy showed 40-45 red cells/high power field. Urine culture was sterile. Radiological investigations showed a focal mucosal lesion with bladder wall thickening. Biopsy of the lesion revealed an edematous mucosa with florid infiltration by eosinophils into the muscularis propria with focal areas of myonecrosis. He was diagnosed as a case of eosinophilic cystitis. The patient received 6 weeks of tapered prednisone therapy. He was asymptomatic on followup.
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Salman M, Al-Ansari AA, Talib RA, El Malik EF, Al-Bozaom IA, Shokeir AA. Eosinophilic cystitis simulating invasive bladder cancer: a real diagnostic challenge. Int Urol Nephrol 2006; 38:545-8. [PMID: 17115289 DOI: 10.1007/s11255-006-0103-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2006] [Accepted: 04/04/2006] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To report our experience with eosinophilic cystitis (EC) presented as invasive bladder cancer. MATERIALS AND METHODS We recently treated three patients with bladder masses mimicking neoplasms and biopsy proved the diagnosis of EC. Data from our three patients were presented. RESULTS There were two females and one male with ages of 14, 43 and 38 years. All the three patients had irritative bladder symptoms, suprapubic pain and hematuria. Bladder mass was detected by pelvic examination in the three patients and confirmed by radiologic tests and cystoscopy. In one patient, the mass caused bilateral hydroureteronephrosis while the upper tract was normal in the other two. Elevated serum leukocytes was evident in the three cases while peripheral eosinophilia was observed in one. Biopsy showed EC in all the three patients who were treated by transurethral resection of the lesions followed by a combination of corticosteroids, antibiotics and antihistaminics. All patients experienced marked improvement during a follow-up duration up to 30 months. CONCLUSION EC is a rare disease. In addition to symptoms of frequency, dysuria, hematuria and suprapubic pain, the disease may present with a bladder mass mimicking invasive bladder cancer. Resection of the lesion is mandatory with systemic treatment of corticosteroids, antihistaminics and antibiotics. Early detection and prompt treatment usually result in a good prognosis.
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Affiliation(s)
- Muwafak Salman
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
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Thompson RH, Dicks D, Kramer SA. Clinical manifestations and functional outcomes in children with eosinophilic cystitis. J Urol 2006; 174:2347-9. [PMID: 16280840 DOI: 10.1097/01.ju.0000180423.06285.72] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Eosinophilic cystitis is a rare disorder, with fewer than 30 pediatric cases reported in the literature. We describe our experience with pediatric eosinophilic cystitis during a 20-year period. MATERIALS AND METHODS Four children referred to our institution were subsequently diagnosed with eosinophilic cystitis between 1984 and 2004. A retrospective chart review was performed to assess clinical presentation, diagnosis, treatment and outcomes. RESULTS Mean patient age at presentation was 10.8 years (range 5 to 18) and male-to-female ratio was 3:1. All 4 patients presented with irritative urinary symptoms, including 3 with dysuria and/or gross hematuria and 2 with urinary frequency, lower abdominal pain and/or a concomitant urinary tract infection. Allergic diseases (asthma, allergic rhinitis, etc) were present in 3 patients, and a formal allergen skin test was positive in 2 of those tested. A bladder mass mimicking malignancy was documented in 2 patients. Three patients had symptom resolution with conservative treatment, while 1 had development of an unremitting tumefactive process that eventually required partial cystectomy and bladder augmentation. CONCLUSIONS Eosinophilic cystitis is a rare condition with a wide range of clinical manifestations. Children can present with a bladder mass mimicking sarcoma, underscoring the need for biopsy before diagnosis and treatment of a presumed oncological process. The condition usually follows a benign course, although unremitting progression remains a possibility.
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Affiliation(s)
- R Houston Thompson
- Department of Urology, Mayo Medical School and Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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Sterrett S, Morton J, Perry D, Donovan J. Eosinophilic cystitis: successful long-term treatment with montelukast sodium. Urology 2006; 67:423.e19-423.e21. [PMID: 16461108 DOI: 10.1016/j.urology.2005.08.059] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2005] [Revised: 08/03/2005] [Accepted: 08/26/2005] [Indexed: 10/25/2022]
Abstract
We report a rare case of eosinophilic cystitis in a 6-year-old boy who presented with irritative voiding symptoms, peripheral eosinophilia, and a bladder mass initially visualized on ultrasonography. Cystoscopy and transurethral biopsy confirmed the diagnosis. Complete resolution of his symptoms occurred within 1 week of corticosteroid use and the x-ray findings improved within 6 weeks. At 6 months of follow-up, the patient continued to require a leukotriene receptor antagonist (montelukast sodium) despite several attempts to discontinue its use. We propose that eosinophilic cystitis in children who present with peripheral eosinophilia will often require long-term treatment.
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Affiliation(s)
- S Sterrett
- Department of Urology, University of Nebraska Medical Center, Omaha, Nebraska 68198-2360, USA.
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Abstract
Eosinophilic cystitis (EC) is a rare clinicopathological condition characterized by transmural inflammation of the bladder predominantly with eosinophils, associated with fibrosis with or without muscle necrosis. The cause of EC remains unclear, although it has been associated with various aetiological factors, such as allergy, bladder tumour, bladder trauma, parasitic infections and chemotherapeutic agents. EC is, probably, caused by the antigen-antibody reaction. This leads to the production of various immunoglobulins, which, in turn, cause the activation of eosinophils and initiates the inflammatory process. The most common symptom complex consists of frequency, haematuria, dysuria and suprapubic pain. Cystoscopy and biopsy are the gold standard for diagnosis. Additional laboratory evidence supporting the diagnosis includes proteinuria, microscopic haematuria and peripheral eosinophilia, the last one occurring in few patients. There is no curative treatment for this condition. Current treatment modalities include transurethral resection of the bladder lesion along with non-specific medical therapy, such as non-steroidal anti-inflammatory agents or steroids. Because the lesion tends to recur in spite of the above therapy, long-term follow-up is mandatory.
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Slama A, Khouni H, Sriha B, Brini K, Ben Sorba N, Taher Mosbah A. [Bladder fibrosis caused by eosinophilic cystitis]. ACTA ACUST UNITED AC 2004; 37:272-4. [PMID: 14606317 DOI: 10.1016/s0003-4401(03)00054-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A 70-years-old man with no history of allergy or genitourinary problems had bilateral hydronephrosis, a marked decrease in bladder capacity and severe eosinophilic infiltration with fibrosis of the bladder wall. A total cystoprostatectomy with ileal bladder replacement was performed. We reviewed the literature of eosinophilic cystitis for clinical presentation, diagnosis and therapeutic options.
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Affiliation(s)
- A Slama
- Service d'urologie, centre hospitalier universitaire Sahloul, 4054 Sousse, Tunisie.
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12
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Clark T, Chang SS, Cookson MS. Eosinophilic Cystitis Presenting As A Recurrent Symptomatic Bladder Mass Following Intravesical Mitomycin C Therapy. J Urol 2002. [DOI: 10.1016/s0022-5347(05)65211-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Travis Clark
- From the Department of Urology, Vanderbilt University, Nashville, Tennessee
| | - Sam S. Chang
- From the Department of Urology, Vanderbilt University, Nashville, Tennessee
| | - Michael S. Cookson
- From the Department of Urology, Vanderbilt University, Nashville, Tennessee
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13
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Eosinophilic Cystitis Presenting As A Recurrent Symptomatic Bladder Mass Following Intravesical Mitomycin C Therapy. J Urol 2002. [DOI: 10.1097/00005392-200204000-00057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Pomeranz A, Eliakim A, Uziel Y, Gottesman G, Rathaus V, Zehavi T, Wolach B. Eosinophilic cystitis in a 4-year-old boy: successful long-term treatment with cyclosporin A. Pediatrics 2001; 108:E113. [PMID: 11731640 DOI: 10.1542/peds.108.6.e113] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
A 4-year-old Jewish boy presented with dysuria, urinary dribbling, increased urinary frequency, and new onset of diurnal enuresis. An infiltrating solid mass involving the entire bladder wall was found. Biopsy revealed "tumor-forming" eosinophilic cystitis, a rare bladder lesion of unclear cause. Antitoxocariasis treatment was unsuccessful. High-dose corticosteroids failed. The child's clinical condition and bladder sonographic findings continued to deteriorate. Treatment with cyclosporin A was given for 8 months, with a complete clinical, radiologic, and histopathologic cure and no side effects. Two years of follow-up showed a complete recovery.
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Affiliation(s)
- A Pomeranz
- Department of Pediatrics, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel.
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INTRAVESICAL DIMETHYL SULFOXIDE INSTILLATIONS CAN BE USEFUL IN THE SYMPTOMATIC TREATMENT OF PROFUSE HEMATURIA DUE TO EOSINOPHILIC CYSTITIS. J Urol 2000. [DOI: 10.1097/00005392-200008000-00046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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INTRAVESICAL DIMETHYL SULFOXIDE INSTILLATIONS CAN BE USEFUL IN THE SYMPTOMATIC TREATMENT OF PROFUSE HEMATURIA DUE TO EOSINOPHILIC CYSTITIS. J Urol 2000. [DOI: 10.1016/s0022-5347(05)67385-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Grønlund A, Glenthøj A, Kvist E. Eosinophilic cystitis--diagnosis and treatment in Denmark. SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY 1999; 33:321-3. [PMID: 10572996 DOI: 10.1080/003655999750017400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the incidence, diagnostic criteria and treatment of eosinophilic cystitis (EC) in Denmark during the period 1989-94. MATERIAL AND METHODS A questionnaire was sent to all Danish departments of surgery, urology and pathology. RESULTS Fifty-six cases of EC were diagnosed in the departments of surgery and urology, and 135 patients were diagnosed in the departments of pathology. The therapy was most often steroid instillation in the bladder or peroral antihistamines. Success rates of treatment were reported to be acceptable. CONCLUSION The questionnaire confirmed that EC is a rare disease, which is often confused with other bladder diseases. We recommend strict histological criteria combined with clinical information when making the diagnosis of EC. Therapy is generally symptomatic. A diagnostic code number from the Danish Health Board is needed.
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Affiliation(s)
- A Grønlund
- Department of Surgery (Division of Urology), Hillerød Hospital, Denmark
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22
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 27-1998. A 10-year-old girl with urinary retention and a filling defect in the bladder. N Engl J Med 1998; 339:616-22. [PMID: 9722434 DOI: 10.1056/nejm199808273390908] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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23
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Bastianello P, Andretta E, Artuso G, Benzone S, Gasparella V, Seren P, Signorelli G. Painful bladder syndromes in the female: Suggestion of an algorithm. Urologia 1997. [DOI: 10.1177/039156039706400132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The problems of diagnosis and therapy in patients with irritation and dysfunction of the lower urinary tract (sometimes encompassing the genitals with resulting emotive involvement), as well as the existence of “idiopathic urethrocystalgias” of unknown origin (apart from the known inflammatory, neoplastic, neurological, gynecological and other pathologies) have led the authors to produce an algorithm aimed at simplifying the diagnostic routine and at summing up the whole subject in an orderly fashion.
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Affiliation(s)
| | - E. Andretta
- Divisione Urologica - Ospedale di Dolo (Venezia)
| | - G. Artuso
- Divisione Urologica - Ospedale di Dolo (Venezia)
| | - S. Benzone
- Divisione Urologica - Ospedale di Dolo (Venezia)
| | | | - P. Seren
- Divisione Urologica - Ospedale di Dolo (Venezia)
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Giordano R, Pellizzari L. Painful bladder syndromes in the female: Anatomopathological aspects. Urologia 1997. [DOI: 10.1177/039156039706400124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The most common and least understood disease that falls under the painful bladder definition is interstitial cystitis. The term interstitial cystitis can be misleading, since in many cases it refers to a process that pathologically is neither interstitial nor inflammatory. Interstitial cystitis remains essentially a diagnosis of exclusion. Biopsy and cytology are essential to rule out carcinoma in situ and other pathological conditions.
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Affiliation(s)
- R. Giordano
- Servizio di Anatomia e Istologia Patologica e di Citodiagnostica - ULSS 13 - Ospedale di Dolo (Venezia)
| | - L Pellizzari
- Servizio di Anatomia e Istologia Patologica e di Citodiagnostica - ULSS 13 - Ospedale di Dolo (Venezia)
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Ficarra V, Beltrami P, Tontodonati M, Giusti G, Zanon G, D'Amico A, Malossini G, Comunale L. Endoscopic treatment of eosinophilic cystitis. Urologia 1996. [DOI: 10.1177/039156039606301s36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Since 1990 we have treated 11 cases of eosinophilic cystitis. All patients were adult or elderly men with an average age of 66.4 years (range 46–83). Seven patients had previous superficial bladder cancer and 5 of these were treated with instillations of mitomycin C. Three patients were hospitalized following repeated episodes of macrohematuria. One case had peritonitis due to spontaneous rupture of the bladder. Cystoscopy showed hyperemic areas in all patients, mamillated areas in 7 cases and ulcerated and necrotic areas in 2 cases. The bladder mucosa appeared bloody in one patient. In nine cases multiple biopsies and wide fulguration of involved areas were performed. Two patients were submitted to complete resection of the lesions. The pathological examination documented an infiltration of eosinophils into the mucosa and lamina propria in all cases; in one of these the infiltration involved the muscularis. The patients have been followed for 24.5 months (range 13–37), with periodic cystoscopy and bladder biopsies. We have not documented recurrences of eosinophilic cystitis. Although the treatment of eosinophilic cystitis is controversial, our experience with diathermic fulguration or transurethral resection has proved effective with minimal invasiveness.
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Affiliation(s)
- V. Ficarra
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona * Servizio Autonomo di Urologia - Ospedale Maggiore - Verona
| | - P. Beltrami
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona * Servizio Autonomo di Urologia - Ospedale Maggiore - Verona
| | - M. Tontodonati
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona * Servizio Autonomo di Urologia - Ospedale Maggiore - Verona
| | - G. Giusti
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona * Servizio Autonomo di Urologia - Ospedale Maggiore - Verona
| | - G. Zanon
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona * Servizio Autonomo di Urologia - Ospedale Maggiore - Verona
| | - A. D'Amico
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona * Servizio Autonomo di Urologia - Ospedale Maggiore - Verona
| | - G. Malossini
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona * Servizio Autonomo di Urologia - Ospedale Maggiore - Verona
| | - L Comunale
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona * Servizio Autonomo di Urologia - Ospedale Maggiore - Verona
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Abstract
Eosinophilic cystitis (EC) is a rare form of bladder inflammation of uncertain etiology, characterized by eosinophilic inflammation of the bladder. Presenting clinical symptoms include hematuria, dysuria, frequency, and suprapubic pain. To our knowledge, there have been only two other reports of computed tomographic (CT) scan findings of EC. In both cases, the findings were thought to represent invasive bladder cancer. We present a case report of biopsy-proven EC with previously unreported CT scan findings.
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Affiliation(s)
- K A Barry
- Department of Diagnostic Radiology, William Beaumont Hospital, Royal Oak, MI 48073
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27
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Hansen MV, Kristensen PB. Eosinophilic cystitis simulating invasive bladder carcinoma. SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY 1993; 27:275-7. [PMID: 8351485 DOI: 10.3109/00365599309181265] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A case of eosinophilic cystitis simulating an invasive bladder carcinoma is reported. The disease had a subacute course and was associated with arthritis of the symphysis pubis and both sacroiliacal joints.
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Affiliation(s)
- M V Hansen
- Department of Surgery, Central Hospital, Fredrikstad, Norway
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