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Cystitis Glandularis

Cystitis glandularis is a term denoting the transformation of the transitional epithelium of the urinary bladder into columnar, presumably due to irritation by infectious agents, stones, neoplastic disorders or other processes. The eventual formation of cysts can lead to symptoms resembling a urinary tract infection - abdominal pain, hematuria, dysuria, nocturia, increased urinary frequency, etc. Its potential to proliferate into a malignant tumor is still a topic of discussion. A biopsy is necessary to confirm the diagnosis.


Presentation

Cystitis glandularis is considered to be a proliferative lesion of the bladder mucosa that develops as a result of metaplasia of the urinary bladder epithelium, transforming from transitional to simple columnar (with or without mucus production) [1] [2] [3] [4] [5]. Its pathogenesis is assumed to include chronic irritation and typical examples are infections of the urinary tract, calculi, obstruction, or tumors [2] [3] [5]. Because of its frequent propensity to protrude into the submucosa and the lamina propria (forming von Brunn's nests or buds that progress into mucin-secreting goblet cells, thus the term cystitis glandularis), several studies have examined the possible premalignant nature of this condition, but solid evidence are yet to be obtained [1] [2] [5]. In addition, pelvic lipomatosis is another clinical entity associated with the occurrence of this disease, presumably by contributing to long-term infection of the lower urinary tract and its obstruction [2]. The exact prevalence rate remains largely undetermined, but isolated studies show that its presence is noted in approximately 2.4% of children who suffered from a urinary tract infection (UTI) [2] [3]. Signs and symptoms like abdominal or flank pain, pelvic/perineal discomfort, increased urinary frequency and urgency, dysuria, nocturia, enuresis, hematuria, and vomiting (in rare cases) are complaints that have been reported in the literature [2] [4] [5] [6].

Workup

The diagnosis may be difficult to make without a thorough clinical and imaging investigation. Physicians must start the workup by obtaining a detailed patient history that will reveal the duration of symptoms, their onset, and determine if preexisting irritative factors exist (chronic infection, history of calculi in the urinary tract, catheterization, etc.). Some of the findings, such as perineal discomfort or abdominal pain, can be confirmed during the physical examination. To identify cystitis glandularis as the underlying cause of associated symptoms, however, imaging studies need to be employed. Cystoscopy is a useful tool to visualize the lesion, which shows a cobblestone pattern of the mucosa, or in some cases, a papillary or polypoid mass [2] [4]. Because of its appearance, the provisional diagnosis of a malignant tumor is often made, thus a biopsy sample, regarded as the gold-standard of the diagnostic workup, with the subsequent pathological examination, is necessary to solidify clinical suspicion [2] [4]. Computed tomography (CT) and magnetic resonance imaging (MRI) have also been described as potentially useful methods [2]. Low signal intensity on both T1 and T2-weighted studies (with a high-intensity pattern in the center) are seen on MRI studies [2].

Treatment

  • Treatment included whole bladder neodymium:YAG laser therapy, a technique not previously reported for this extent of disease. The etiology, diagnosis, treatment and malignant potential of cystitis glandularis are discussed.[ncbi.nlm.nih.gov]
  • Antibiotic therapy treatment Antibiotic therapy is a kind of conservative treatment, which aims to eliminate chronic tract infections.[darlywhite.wordpress.com]
  • The endoscopic resection, with long-term antibiotic prophylaxis, was the treatment of choice, with no recurrence at 12-30 months of follow-up.[ncbi.nlm.nih.gov]
  • Contains a new section on painful and irritative voiding disorders, including a discussion of overactive bladder and the latest treatment options available.[books.google.de]

Prognosis

  • 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.de]
  • Treatment and prognosis Treatment consists of removing the source of irritation and surgical excision of the area of inflammation or cystectomy in rare severe cases.[radiopaedia.org]
  • Due to lack of this evidence and prognosis, we report a case of a 16-year-old male presenting with dysuria and a space occupying lesion in the bladder masquerading as a tumor mass.[medresearch.in]
  • CLINICAL ISSUES Presentation Usually incidental finding When florid, small raised lesion with intact urothelium may be seen Rare cases with intestinal metaplasia and extensive mucin extravasation may form large mass lesion that can mimic malignancy Prognosis[basicmedicalkey.com]

Etiology

  • The etiology, diagnosis, treatment and malignant potential of cystitis glandularis are discussed.[ncbi.nlm.nih.gov]
  • Etiologically and histologically cystitis glandularis mimics Barrett's metaplasia. We investigated the roles of beta-catenin and TNFalpha in cystitis glandularis.[ncbi.nlm.nih.gov]
  • […] ultimately confirmed by histopathologic examination.There are a lot of therapeutic methods,including surgery,drug infusion therapy,radiation therapy and biological therapy;most patients choose the comprehensive treatment of surgery drug perfusion,but etiological[en.cnki.com.cn]
  • […] 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]
  • Although its etiology is unknown, cystitis glandularis has been associated with chronic stimulation of the mucosa of the urinary bladder due to urinary tract infection, obstruction, and indwelling catheters, which may lead to overproductive changes in[bjn.org.br]

Epidemiology

  • Home Literature Reviews Epidemiology/Genetics Women With IC More Likely to Have Cystitis Glandularis, Chinese Study Suggests Zhang W, Yao YS, Lin ME, Xie WJ, Pan WW.[ichelp.org]
  • Oravisto KJ (1975) Epidemiology of interstitial cystitis. Annales chirurgiae et gynaecologiae Fenniae 64(2):75–77 15. Jones CA, Nyberg L (1997) Epidemiology of interstitial cystitis. Urology 49(5ASuppl):2–9 16.[springermedizin.de]
  • 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.de]
  • 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]
Sex distribution
Age distribution

Pathophysiology

  • Immunohistochemistry showed positive signals of cyclooxygenase-2 in the epithelium of pretreatment specimens, suggesting the pathophysiological role of cyclooxygenase-2 in cystitis glandularis.[ncbi.nlm.nih.gov]
  • In a revision of 1000 biopsies, performed to investigate bladder cancer, the authors found EC in only 1,7%. 7 The etiology and pathophysiology of EC is not well understood.[ispub.com]
  • Eosinophilic cystitis: the relationship of allergy in the urinary tract to eosinophilic cystitis and the pathophysiology of eosinophilia. J Urol 1974; 112: Slama A, Khouni H, Sriha B, Brini K, Ben Sorba N, Taher Mosbah A.[docplayer.net]
  • Pathophysiology Acute Uncomplicated Cystitis Acute uncomplicated cystitis is an inflammation of the urinary bladder that occurs in the absence of any structural or functional pathology.[wikidoc.org]
  • Eosinophilic cystitis: the relationship of allergy in the urinary tract to eosinophilic cystitis and the pathophysiology of eosinophilia . J Urol 1974; 112: 457. 33. Slama A, Khouni H, Sriha B, Brini K, Ben Sorba N, Taher Mosbah A.[giornalechirurgia.it]

Prevention

  • Building healthy eating habit and prevent cystitis glandular Eat more diuretic food, such as water melon, grape, pineapple, celery, pear, etc.[99eyao.com]
  • . / Matsuda, T. 2016 709 Editorial Comment to Novel strategy for cystitis glandularis: Oral treatment with cyclooxygenase-2 inhibitor Takahashi, S. 2016 710 First use of KORING to prevent parastomal hernia in robot-assisted ileal conduit formation Schmitz[tib.eu]
  • (NaturalNews) Slowly, studies within conventional medicine’s research facilities support what alternative and holistic practitioners have known for some time: Vitamin D3 helps prevent and cure disease, including cancer.[albertopansadoro.it]
  • Stasis of urine flow allows entry of pathogens into the urinary tract and also hinders the natural preventive mechanism by which urine flushes away the pathogens and prevents colonisation in the urinary tract. [1] [5] [6] [7] Recurrent/Chronic cystitis[wikidoc.org]
  • Stress reduction can benefit the immune system and help to treat and prevent UTIs. [4] Naturopathic Therapies The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal[ndhealthfacts.org]

References

Article

  1. YI X, LU H, WU Y, et al. Cystitis glandularis: A controversial premalignant lesion. Oncol Lett. 2014;8(4):1662-1664.
  2. Wong-You-Cheong JJ1, Woodward PJ, Manning MA, Davis CJ. From the archives of the AFIP: Inflammatory and nonneoplastic bladder masses: radiologic-pathologic correlation. Radiographics. 2006;26(6):1847-1868.
  3. Capozza N, Collura G, Nappo S, de Dominicis M, Francalanci P, Caione P. Cystitis glandularis in children. BJU Int. 2005;95:411–413.
  4. Michajłowski J, Matuszewski M, Kłącz J, Gibas A, Biernat W, Krajka K. Acute urinary retention in a patient with extended cystitis glandularis. Cent European J Urol. 2011;64(2):94-96.
  5. Yuksel OH, Urkmez A, Erdogru T, Verit A. The role of steroid treatment in intractable cystitis glandularis: A case report and literature review. Can Urol Assoc J. 2015;9(5-6):E306-E309.
  6. Li A, Liu S, Lu H, et al. Clinical character of cystitis glandularis accompanied with upper urinary tract obstruction. Can Urol Assoc J. 2013;7(11-12):E708-E710.

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Last updated: 2018-06-22 03:39