Clinicopathological characteristics and outcomes of eosinophilic cystitis: A retrospective study

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.

A Rare Case of Xanthogranulomatous Cystitis Mimicking Bladder Malignancy in Nigeria: A Case Report and Review of Literature

“…The histopathologic features of XC are foamy (lipid-laden) macrophages with multinucleated giant cells and mixed inflammatory cells, including lymphocytes, plasma cells, and neutrophils [ 1 , 3 ]. Although the diagnosis of XC on histopathologic evaluation is usually straightforward, certain differential diagnoses should also be considered and ruled out, such as malakoplakia, eosinophilic cystitis, and florid cystitis cystica et glandularis [ 7 , 8 , 15 ]. Malakoplakia involving the bladder shows similar morphologic features as described for XC but includes the presence of Michaelis-Gutmann bodies (iron-containing, cytoplasmic-laminated concretions) [ 15 ].…”

“…Malakoplakia involving the bladder shows similar morphologic features as described for XC but includes the presence of Michaelis-Gutmann bodies (iron-containing, cytoplasmic-laminated concretions) [ 15 ]. In eosinophilic cystitis, the inflammatory infiltrate includes prominent eosinophils within the lamina propria and muscularis or all layers of the bladder wall, with peripheral eosinophilia in some patients [ 7 ]. Cystitis cystica et glandularis is a common reactive change often seen in a background of chronic mucosal irritation or inflammation; when florid, it may appear as a mass on cystoscopy and may mimic malignancy [ 8 ].…”

“…Clinically and on cystoscopy, XC may mimic a bladder malignancy [ 1 , 6 ]. Other rare forms of cystitis which may also mimic malignancy clinically and on imaging include eosinophilic cystitis and florid cystitis cystica et glandularis [ 7 , 8 ]. These conditions, though benign, may present with solid masses in the bladder, with worrisome features on imaging, and prove quite challenging to diagnose clinically and radiologically, in the absence of histopathologic assessment [ 1 ].…”

Urothelial Papilloma of the Urinary Bladder: A Case Report and Literature Review of a Rare Entity

“…Endoscopic evaluation is the first step for the diagnosis of unusual cystic lesions including UP [8]. Almost all patients have a single small (<2 cm in greatest dimension) lesion commonly located on the posterior or lateral bladder walls in the vicinity of the ureteric orifices.…”

Vesical varices: An uncommon cause of gross hematuria in young men

“…Usually, varices due to portal hypertension develop in the gastroesophageal region [ 1 ]. The hematuria due to unusual conditions including vesical varices could be life threatening [ 2 , 3 ]. The determination of the etiology of the varices and the efficient treatment is quite challenging.…”