Diagnosis Of Eosinophilic Cystitis Research Articles

Eosinophilic Cystitis Presenting as Possible Pediatric Rhabdomyosarcoma in Conventional Imaging Including 18F-FDG-PET/CT/MRI-A Rare Case.

Eosinophilic cystitis (EC) is a relatively rare, but benign inflammatory bladder disease compared to that of the malignant pediatric rhabdomyosarcoma (RMS), in which it can be mimicking on initial suspicion. The origin, symptoms and findings of both EC and RMS are still discussed and hence, lead to the challenge in distinguishing them by cystoscopy and several image modalities. We present a case in which cross-sectional imaging modalities including fluorine-18-fluro-2-deoxy-D-glucose (18F-FDG)-positron emission tomography (PET) / computed tomography (CT) / magnetic resonance imaging (MRI) (18F-FDG-PET/CT/MRI (The imaging modality 18F-FDG-PET/CT/MRI referring to two continuous scans scanned on the same 18F-FDG-tracer dose for both the whole-body 18F-FDG-PET/CT and the regional 18F-FDG-PET/MRI of the pelvis.)) raised suspicion of RMS. Hence, the final diagnosis of EC was established by repeated histopathology. It is important to have EC in mind when seeking differential diagnosis of malignant diseases like RMS in order to provide the correct treatment for the patient and highly homogenously increased 18F-FDG-uptake should raise the suspicion of EC as a differential diagnosis. Furthermore, 18F-FDG-uptake rate is suggested as a future potential biomarker for monitoring of therapeutic response in eosinophilic inflammatory diseases, thus more research on this topic is needed.

Eosinophilic cystitis mimicking muscle-invasive bladder cancer: a case report and literature review

Objective To evaluate the clinical and pathological features of eosinophilic cystitis (EC), and to discuss its diagnosis and treatment. Methods The clinical and pathological data of one case of eosinophilic cystitis were reported. An 86-year-old male with gross hematuria and urinary urgency for 15 days was admitted on 16 March 2015. A computed tomography scan showed uneven thickening of the bladder wall and a nodular soft tissue on the anterior wall protruding into the bladder cavity. Results Cystoscopic examination showed diffuse thickening of the bladder with polypoid red lesions on the anterior wall. Transurethral biopsies revealed infiltrating eosinophils, which was consistent with the diagnosis of EC. The patient was then treated with anti-inflammatory drugs, corticosteroids and anti-histamine drugs. At 6 months of follow-up, the patient was asymptomatic and had no evidence of local recurrence by ultrasonography. Conclusions Eosinophilic cystitis is a rare disease without specific clinical and imaging features, which can mimic bladder tumor. The final diagnosis of this disease depends on the pathology. Transurethral resection of the lesion along with postoperative hormone and antihistamines administration are the main choices of treatment. Key words: Eosinophilic cystitis; Dysuria; Diagnosis; Therapy

The Spectrum of Eosinophilic Cystitis in Males: Case Series and Literature Review

Eosinophilic cystitis (EC) is an inflammatory condition of the bladder that has been linked to food allergens, infectious agents, drugs, and other genitourinary conditions. Like interstitial cystitis, EC has a strong female predominance. It is characterized by an intense eosinophilic infiltrate in the acute phase and fibrosis in the chronic phase. To document and focus on specific features of EC in males and highlight the relationship between clinical and histopathologic findings. The bladder biopsies of male patients were reviewed. Eight cases of EC were selected. Several known associations were noted as well as unreported features and associations such as Charcot-Leyden crystals, celiac disease, lupus anticoagulant, and additional viral and bacterial agents. Eosinophilic cystitis represents a response to a variety of agents and may often be overlooked. The temporally biphasic morphologic features are the hallmark of this condition. Because clinical and imaging studies are not specific, a high index of clinical suspicion is often crucial to the correct diagnosis and proper management of EC.

Eosinophilic cystitis simulating invasive bladder cancer: a real diagnostic challenge

To report our experience with eosinophilic cystitis (EC) presented as invasive bladder cancer. We recently treated three patients with bladder masses mimicking neoplasms and biopsy proved the diagnosis of EC. Data from our three patients were presented. 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. 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.

EOSINOPHILIC CYSTITIS IN A NEONATE

A 4-week-old black full-term female underwent evaluation of an incidental bladder mass discovered during evaluation for microscopic hematuria and oliguria. The patient had a milk protein allergy leading to severe dehydration and cerebral thrombosis. Prenatal and urological history was unremarkable. Urine cultures were negative and peripheral eosinophilia was not present. Renal and bladder ultrasound, voiding cystourethrogram and magnetic resonance imaging all demonstrated a bladder mass along the posterior wall of the bladder, and normal kidneys (figs. 1 and 2). Cystoscopy confirmed a solid midline trigonal mass. Transurethral excisional biopsy was performed, and pathological examination revealed the presence of fibroconnective tissue withch ronic inflammatory infiltrate composed of lymphocytes and eosinophils, consistent with the diagnosis of eosinophilic cystitis. Due to the self-limited nature of this asymptomatic problem and lack of malignant degeneration, we chose to observe the patient. Followup bladder ultrasound at 6 weeks and 3 months showed a small residual bladder mass. DISCUSSION

Extensive Inflammatory Eosinophilic Bladder Tumors in Children: Experience With Three Cases

Eosinophilic cystitis, an uncommon lesion, is rare in children; < 25 cases have been reported. The intense inflammatory changes in the bladder wall associated with this lesion may produce heaped-up excrescences, which resemble vesical rhabdomyosarcoma. Our experience with 3 patients shows that the initial diagnosis of eosinophilic cystitis may not be easily made, and that the lesions produced may mask other disease processes. We alsoreport the fifth case of eosinophilic infiltration of the bladder occurring in association with chronic granulomatous disease.

Eosinophilic cystitis in children

A case of eosinophilic cystitis in a child is presented and the pediatric literature reviewed. The etiology of this condition is still unknown. Mean age of children with eosinophilic cystitis is 5.9 years. Black children appear to be more affected than white children, with a male preponderance. Hematuria and dysuria are the most common symptoms. The diagnosis of eosinophilic cystitis is made by cystoscopy with biopsy. The disease appears self-limited with its course unaltered by antibiotics. Recurrence of eosinophilic cystitis is possible.