Urocystitis cystica

Classification according to ICD-10
N30.8	Urocystitis cystica
N28.8	Cystic pyelitis
N28.8	Cystic ureteritis
ICD-10 online (WHO version 2019)

Under a Urocystitis cystica ( cystitis cystica ) is understood to metaplastic changes submucosal Urothelaussprossungen (von Brunn-epithelial nests) in the area of the bladder mucosa with formation of cystic structures . In principle, similar changes are also observed in the renal pelvis ( pyelitis cystica ) and the ureter ( ureteritis cystica ).

etiology

The cause of the metaplastic changes is unknown. Contrary to the term urocystitis ( inflammation of the bladder ), which has been retained for historical reasons , inflammatory changes are not necessary for this, nor are there any accompanying inflammatory changes.

Epidemiology

In the unselected autopsy material, corresponding changes were found in 78 percent of the men and 91 percent of the women.

pathology

Histology of urocystitis glandularis et cystica with intestinal metaplasia.

Macroscopically , multiple, up to 2–5 mm large, cystic protrusions of the urinary bladder mucosa are often seen, preferably in the area of ​​the bladder outlet, the trigonum vesicae and the ureter openings . With the appropriate expansion, a cobblestone-like aspect can result.

Histologically , one finds cystic structures lined with flat to cubic epithelium , which sometimes contain homogeneous, eosinophilic , PAS-positive material (uromucoid) in the lumen . Alternatively, the cysts can also be lined with an alternatingly wide urothelium, the innermost cell layer being formed by a light, cylindrical epithelium with basal nuclei ( urocystitis glandularis , non-intestinal type). As a third variant, intestinal metaplasia with the formation of mucus-forming epithelia is sometimes observed ( urocystitis glandularis , intestinal type). It is not uncommon for these forms to be found in combination ( urocystitis glandularis et cystica with or without intestinal metaplasia).

clinic

Urocystitis cystica usually causes no symptoms and therefore does not require any therapy. Urinary flow disorders can rarely occur. However, the change must be differentiated from urinary bladder tumors, especially adenocarcinomas , whose cystoscopic and histological picture it can imitate.

Individual evidence

1. ↑ ^{a b c d e} W. Remmele: Pathology. Volume 5, 2nd edition. Springer, 1997, ISBN 3-540-61098-7 .
2. ↑ ^{a b} U. Riede, M. Werner, H. Schäfer: General and special pathology. 5th edition. Thieme, 2004, ISBN 3-13-683305-8 .

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