Eosinophilic Cystitis

Abstract

Purpose: We present a large series of eosinophilic cystitis including 8 cases; 3 of them had tumor-like lesions. Materials and Methods: The archives of pathology clinic of Inonu University Medical Faculty were reviewed from 1988 to 2002. The characteristics of patients and their diseases were recorded. Data obtained from 180 cases (172 from the literature and 8 from the present series) was assessed. Results: Seven cases had symptoms such as dysuria, frequency, hematuria, suprapubic pain, and difficulty in voiding. One asymptomatic case with history of bladder carcinoma was diagnosed during routine cystoscopy. The findings were microhematuria in 6 cases, macrohematuria in 2, pyuria in 3, urinary infection in 1, eosinophilia in 1, hyperazotemia in 1, and bladder masses in 3. Cystoscopies detected edematous and erythematous areas in 5 cases and lesions mimicking bladder carcinoma in 3. One case did not take further treatment after cystoscopy and biopsy and completely recovered. Four cases underwent medical therapy with nonsteroidal anti-inflammatory drugs and antihistaminics. They became asymptomatic and control cystoscopies showed no abnormal finding. Two of three patients with mass lesions recovered after steroid therapy following transurethral resection. The lesion in the third recurred and he improved after a second course of steroid therapy. Conclusions: Eosinophilic cystitis is a rare pathology. Sometimes, it may simulate bladder malignancies. Biopsy is mandatory at diagnosis. Usually, it has a benign course and may be treated with fulguration, analgesics, antihistaminics and steroids, although recurrence is possible.

Genito-urinary polyps: summary of the 10-year experiences of a single institute

“…These examinations can reveal hydronephrosis, filling defect, irregular bladder wall, wall thickening, bladder contracture, and bladder masses in some cases [27]. Cystoscopy is a very important examination and reveals edematous, ulcerative, or hyperemic mucosal lesions [27]. Cases in the series presented here are the first reported cases of eosinophilic cystitis presenting as a incidentally detected polypoidal lesion in the bladder of patients with benign prostatic hyperplasia.…”

“…Eosinophilic cystitis is a rare inflammatory lesion of the bladder that is characterized by massive eosinophilic infiltrates of the bladder wall [27]. According to one report, the incidence of eosinophilic cystitis for 1000 bladder biopsies performed for the suspicion of having bladder tumor was 1.7% [28].…”

“…The disease has been reported in all age groups from 5 days to 87 years, with a lower frequency in children. Men are more often involved than women [27]. The etiology of eosinophilic cystitis has remained poorly understood, but it likely has an immunological origin [29].…”

“…The etiology of eosinophilic cystitis has remained poorly understood, but it likely has an immunological origin [29]. The most predominant symptoms of the disease are frequency (68.3%), dysuria (61.7%), hematuria (58.96%), pain (48.9%), urinary retention (11.1%), and nocturnal enuresis (4%) [27]. An excretory urogram (IVP) and computed tomography have been used to define the abnormal conditions related to the disease.…”

“…An excretory urogram (IVP) and computed tomography have been used to define the abnormal conditions related to the disease. These examinations can reveal hydronephrosis, filling defect, irregular bladder wall, wall thickening, bladder contracture, and bladder masses in some cases [27]. Cystoscopy is a very important examination and reveals edematous, ulcerative, or hyperemic mucosal lesions [27].…”