Cystitis cystica usually develops in the elderly and occasionally in children, a prevalence of 2.4% has been reported in children with urinary tract infections [1]. It has the same clinical presentation as cystitis, but on cystoscopy it can be mistaken for a malignant lesion. Cystitis cystica is considered a premalignant condition and may progress to adenocarcinoma of the bladder [2].

Frequently no specific symptoms can be attributed to the disease and it is mostly detected incidentally by ureteroscopy or radiography for other complaints. However, in symptomatic cases, painless hematuria and various other symptoms such as dysuria, urinary frequency and urgency occur. Mucus may rarely be secreted in the urine. Cystitis cystica affecting the orifices of ureters in the bladder can contribute to reflux. The bladder neck involvement may result in vesical outlet obstruction [3] [4] [5] [6] [7].

• Pathologist

  Edited by four leading surgical pathologists - Noel Weidner, MD, Richard J. Cote, MD, Saul Suster, MD and Lawrence M. [books.google.de]

  This narrative collects most of them from a clinical and pathologic perspective, offering urologists and general pathologists their most salient definitory features. [read.qxmd.com]

  A pathologist can determine what kinds of cells are involved and provide information about how rapidly they are growing. After diagnosis, treatment can include medications to resolve inflammation and surgery to remove irritants like stones. [wisegeekhealth.com]

  Abstract Tumor-like lesions of the urinary bladder are reviewed emphasizing those that are most diagnostically challenging for the pathologist and may result in serious errors in patient care if misinterpreted. [nature.com]

  18/38 (47%) cases reported by Jacobs et al. [13] In the literature, though the incidence of CGIT is reported to be less than CG usual type, [4] the relatively high incidence of CGIT in this and other studies [13] is probably due to the likelihood of pathologists [ijpmonline.org]

• Fever

  Usual symptoms are frequent urination with burning pain, blood in the urine, and pain in the pubic area; chills and fever, back pain, and nausea may indicate kidney involvement. [encyclopedia2.thefreedictionary.com]

  When to see a doctor Seek immediate medical help if you have signs and symptoms common to a kidney infection, including: Back or side pain Fever and chills Nausea and vomiting If you develop urgent, frequent or painful urination that lasts for several [mayoclinic.org]

  Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized [nejm.org]

• Swelling

  In cystitis cystica, the center of the nest of urothelium undergoes liquefaction to produce cystic swellings. Cystitis cystica is also present in 60% of normal bladders. [health24.com]

  With cystic acne, bacteria also gets into the pores, causing swelling or inflammation. Cystic acne is the most severe type of acne. Acne cysts are often painful and more likely to cause scarring. [my.clevelandclinic.org]

  The most frequent variety of follicular CG is a sheet-like infiltrating type of follicular edema, swelling, or villous hyperplasia. Villous edema CG is most commonly found in the bladder neck and resembles a papilloma. [jxym.amegroups.com]

• Nausea

  Usual symptoms are frequent urination with burning pain, blood in the urine, and pain in the pubic area; chills and fever, back pain, and nausea may indicate kidney involvement. [encyclopedia2.thefreedictionary.com]

  […] urgent need to go, often only passing small amounts Urgency even when the bladder is empty Dark or cloudy urine, strong smelling urine Other symptoms can include: Backache/pain over the bladder Fever or raised temperature, chills Blood in urine Fatigue Nausea [bladder-help.com]

  When to see a doctor Seek immediate medical help if you have signs and symptoms common to a kidney infection, including: Back or side pain Fever and chills Nausea and vomiting If you develop urgent, frequent or painful urination that lasts for several [mayoclinic.org]

• Vomiting

  When children have cystitis, they may have any of the symptoms listed above, plus vomiting and general weakness. [medicalnewstoday.com]

  When to see a doctor Seek immediate medical help if you have signs and symptoms common to a kidney infection, including: Back or side pain Fever and chills Nausea and vomiting If you develop urgent, frequent or painful urination that lasts for several [mayoclinic.org]

• Sweating

  You can lower your risk of getting acne by taking these steps: Use a mild foaming facial cleanser, lukewarm water and your fingers (not a washcloth or sponge) to wash your face after you wake up, before going to bed and after exercising or sweating. [my.clevelandclinic.org]

  1）外陰 梅毒：lues, condyloma latum 尖形コンジローマ：condyloma acuminatum 扁平コンジローマ：flat condyloma ボウエン病（上皮内癌）：Bowen's disease (carcinoma in situ) 扁平上皮癌：squamous cell carcinoma パジェット病：Paget's disease 基底細胞癌：basal cell carcinoma 乳頭状汗腺腫：hidradenoma papillliferum 汗腺癌：sweat [medical-e.net]

• Dysuria

  However, in symptomatic cases, painless hematuria and various other symptoms such as dysuria, urinary frequency and urgency occur. Mucus may rarely be secreted in the urine. [symptoma.com]

   Irritative voiding symptoms:  Frequency  Dysuria  Urgency  Bacteruria  Gross hematuria  Chronic UTI  They may complain of voiding mucus  Less frequently: ureteral obstruction and subsequently hydronephrosis. 12. [slideshare.net]

  Nine months following transurethral fulguration, 8/11 (72.7%) patients were in complete remission and 1/11 (9.1%) complained of urgency and dysuria; two patients were lost to follow‑up. [spandidos-publications.com]

  Gross hematuria was the most common presenting symptoms followed by increased frequency of micturition and dysuria. Eight patients (5.12%) had hydroureteronephrosis at presentation. [indianjurol.com]

• Burning Micturition

  A 60-year-old male presented with complaints of hematuria, burning micturition, irritative, and obstructive urinary symptoms for 15 days. [ijmsweb.com]

  There was no history of fever and burning micturition. [afju.springeropen.com]

The differential diagnoses of cystitis cystica include intestinal metaplasia, the nested variant of urothelial carcinoma and adenocarcinoma [8] [9].

On cystoscopy, nodules are often found in the bladder neck and trigone region and the mucosa has a cobblestone pattern. The muscular layer should be unaffected, which is considered a feature that can distinguish cystitis cystica from urothelial carcinoma. A young age of a patient should raise the suspicion that the lesion is benign, but a cystoscopic biopsy is required to make a definitive diagnosis. Histological evaluation reveals nests of columnar epithelial cells in the submucosa that surround a central region of liquefied columnar degeneration [3] [10] [11] [12].

Earlier the preferred diagnostic tools for cystitis cystica were intravenous pyelography (IVP) and retrograde urography. However, magnetic resonance tomography and computed tomography have become more accurate and available. Despite these technical advances, imaging studies can be inadequate to diagnose some patients in which case a cystoscopy is the definite approach used for diagnosis [4] [13]. Using imaging modalities, cystitis cystica generally appears as discrete and multiple masses that elevate the urothelium. However, the radiological appearances are non-specific and may be mistaken for a malignancy [7] [14].

• Staphylococcus Aureus

  Other micro-organisms include Pseudomonas, Proteus, Chlamydia and Staphylococcus aureus [13]. There are numerous risk factors; however, in many cases described, no cause has been formally identified. [scirp.org]

  Saprophyticus Staphylococcus Aureus[32] Lactobacillus Group B Streptococci Pseudomonas Fungi Candida Viruses HIV[33] Adenovirus[34] Cytomegalovirus[35] Polyoma viruses (JC and BK) Parasite Toxoplasma Gondii[33] Classification according to duration and [wikidoc.org]

Conservative treatment and TUR of the lesions had no effect on the symptoms. [ncbi.nlm.nih.gov]

Treatment of cystitis cystica is difficult and long-lasting. Here, the authors present their experience on the diagnosis and treatment of patients with cystitis cystica. [termedia.pl]

Contains a new section on painful and irritative voiding disorders, including a discussion of overactive bladder and the latest treatment options available. [books.google.com]

A plethora of treatments ranging from simple observation, treatment of infection, removal of irritant, excision of the lesion, TUR[6] to more extensive procedures such as resection of bladder, ureter, and PUJ have been reported. [bioline.org.br]

A urologist is usually involved in diagnosis and treatment. People develop cystitis cystica as a result of chronic irritation and inflammation in the bladder. [wisegeekhealth.com]

Cystitis cystica is a derivative of the focal epithelial proliferation, the associated tumors tend to be non-infiltrating papillary and the prognosis is good. [ncbi.nlm.nih.gov]

Factors 7-49 82 Genetic Predisposition and Syndromic Associations 8-1 83 Clinical Features and Natural History of Bladder Cancer 8-2 84 Morphologic Characteristics of Invasive Urothelial Carcinoma 8-10 85 Urothelial Carcinoma in Young Adults 8-14 86 Prognosis [books.google.com]

Treatment and prognosis Treatment consists of removing the source of irritation and surgical excision of the area of inflammation or, in rare severe cases, cystectomy. [radiopaedia.org]

[…] urothelium within the lamina propria with cyst formation, i.e. lumens are present; no nuclear atypia LM DDx nested urothelial carcinoma, cystitis cystica et glandularis, inverted urothelial papilloma Site urinary bladder - see urothelium Prevalence common Prognosis [librepathology.org]

Etiology and Pathology of Cystitis Cystica Cystitis cystica is an inflammatory reaction of the urothelium to infection or mechanical irritation. Subepithelial vesicles develop with a few mm in size. [urology-textbook.com]

[…] columnar luminal cells are present Cystitis glandularis Cystitis cystica with luminal cuboidal or columnar lining cells Cystitis glandularis with intestinal metaplasia (intestinal type) Cystitis glandularis with at least focal intestinal-type goblet cells ETIOLOGY [basicmedicalkey.com]

"The etiology of urinary tract infection: traditional and emerging pathogens". Am J Med. 113 Suppl 1A: 14S–19S. PMID 12113867. ↑ Hemorrhagic cystitis. [wikidoc.org]

and renal pelvis (pyelitis) Pathophysiology Reactive process in response to chronic irritation, infection, calculi, outlet obstruction, catheterization (Pathol Annu 1995;30:95) Urothelium proliferates and invaginates into underlying lamina propria Etiology [pathologyoutlines.com]

[…] conventional type Cystitis glandularis, intestinal type (preferred term: intestinal metaplasia) Proliferative cystitis (discouraged terminology) ICD coding ICD-10: N30.80 - Other cystitis without hematuria ICD-10: N30.81 - Other cystitis with hematuria Epidemiology [pathologyoutlines.com]

Considerations 7-3 74 Histopathology and Diagnostic Criteria 7-4 75 Variants of Urothelial Carcinoma in Situ 7-9 76 Differential Diagnosis 7-31 77 Diagnostic and Predictive Biomarkers 7-34 78 Prognosis 7-37 79 Molecular Characteristics 7-40 References 7-42 81 Epidemiology [books.google.com]

We report 4 cases of cystitis glandularis, we analyze the epidemiological, clinical, biological, pathological and therapeutic of this affection. In the last 5 years we treated four patients with cystitis glandularis. [webmedcentral.com]

"Population-based epidemiologic analysis of acute pyelonephritis". Clin Infect Dis. 45 (3): 273–80. doi:10.1086/519268. PMID 17599303. ↑ Echols RM, Tosiello RL, Haverstock DC, Tice AD (1999). [wikidoc.org]

This review article aims to describes CG including its epidemiology, pathogenesis and etiology, pathology, classification, diagnosis, identification, therapy. [jxym.amegroups.com]

[…] common: 60% of normal bladders at autopsy (J Urol 1979;122:317) Can occur in males and females at any age (Arch Pathol Lab Med 2012;136:721) Sites Bladder; neck and trigone are most common sites Also ureters (ureteritis) and renal pelvis (pyelitis) Pathophysiology [pathologyoutlines.com]

Pathogenesis and etiology At the moment, the etiology and pathophysiology of CG remain unknown. [jxym.amegroups.com]

Urinary Tract Infections Main Page Cystitis Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Cystitis from other Diseases Epidemiology and Demographics Risk Factors Screening [wikidoc.org]

In the light of this observation, we will discuss the diagnostic difficulties, the pathophysiological mechanisms, the radiological aspects, the anatomopathological, therapeutic features and the prognosis of this rare condition. [openaccesspub.org]

Study results suggested that early control of urinary tract infections by chemoprophylaxis could prevent higher grades of bladder wall mucosal changes and consequently shorten the length of chemoprophylaxis. [ncbi.nlm.nih.gov]

Prevention Cystitis is often not preventable, but the following measures may help: practicing good hygiene after sex using neutral, unperfumed soaps around the genitals. [medicalnewstoday.com]

Prevention Self-care measures to prevent repeated bladder infections aren't well studied. But some providers recommend these tips for prevention: Drink plenty of liquids, especially water. [mayoclinic.org]

[…] cystitis If you get cystitis frequently, there are some things you can try to help prevent it returning. [nhs.uk]

1. Capozza N, Collura G, Nappo S, de Dominicis M, Francalanci P, Caione P. Cystitis glandularis in children. BJU Int. 2005;95:411–413.
2. Nariculam J, Patel A, Murphy D, Rane A. Cystitis Cystica Causing Bilateral Ureteric Obstruction. Internet J Urol. 2006;4(3).
3. Wong-You–Cheong JJ, Woodward PJ, Manning MA, Davis CJ. Inflammatory and Nonneoplastic Bladder Masses: Radiologic-Pathologic Correlation. RadioGraphics 2006;26(6);1847-1868. doi:10.1148/rg.266065126.
4. Menéndez V, Sala X, Alvarez-Vijande R, Solé M, Rodriguez A, Carretero P. Cystic pyeloureteritis: Review of 34 cases. Radiologic aspects and differential diagnosis. Urology. 1997;50(1):31–37. doi:10.1016/s0090-4295(97)00205-7.
5. Rothschild JG, Wu G. Ureteritis Cystica: A Radiologic Pathologic Correlation. J Clin Imaging Sci. 2011;1:23.
6. Vlatković G, Bradić I, Gabrić V, Batinić D. Cystitis cystica: characteristics of the disease in children. Br J Urol. 1977;49(1):57-9.
7. Raja J, Anson K, Patel U. Cystitis cystica and cystitis glandularisPresentation with acute ureteric obstruction. Clinical Radiology Extra. 2003;58(6):43-4.
8. Smith AK, Hansel DE, Jones JS. Role of Cystitis Cystica et Glandularis and Intestinal Metaplasia in Development of Bladder Carcinoma. Urology. 2008;71:915–8.
9. Volmar KE, Chan TY, De Marzo AM, et al. Florid von Brunn nests mimicking urothelial carcinoma: a morphologic and immunohistochemical comparison to the nested variant of urothelial carcinoma. Am J Surg Pathol. 2003;27:1243–52.
10. J Nariculam, A Patel, D Murphy, A Rane. Cystitis Cystica Causing Bilateral Ureteric Obstruction. Internet J Urol. 2006;4(3).
11. Hochberg DA, Motta J, Brodherson MS. Cystitis glandularis. Urology. 1998;51:112–113.
12. Lee G, Tsiriopoulos I, Yajnik K, Smith R, Pancharatnam M. Cystitis glandularis mimics bladder tumour: a case report and diagnostic characteristics. Int Urol Nephrol. 2005;37:713–715.
13. Argüelles Salido E, Rodríguez Corchero J, López García MA, Pérez Espejo MP, Campoy Martínez P, Pena Outeiriño JM. Cystic ureteritis in a kidney transplantation candidate. Actas Urol Esp. 2005;29:226–9.
14. Ito N, Hirose M, Shirai T, Tsuda H, Nakanishi K, Fukushima S. Lesions of the urinary bladder epithelium in 125 autopsy cases. Acta Pathol Jpn. 1981;31(4):545-57.