Hashimoto H, Inada F, Takamura T, Yachiku S
Hinyokika Kiyo. 1985 Nov;31(11):2055-9.
A 63-year-old female visited our department, complaining of miction pain. She had several episodes of urinary occult blood. Urinalysis included a small number of red cells, white cells and bacilli. Physical examination revealed a fist-sized mass of her right flank. Cystoscopic examination showed a botryoid tumor with multiple erythematous raised plaques. Biopsy was reported as massive infiltration of eosinophiles in submucosal layer of the bladder, i.e. eosinophilic cystitis. Antibiotics were effective for the improvement of urine findings and symptoms within a week. IVP and CT revealed the abdominal mass as a retroperitoneal tumor with cystic degeneration, and the tumor was resected. Pathological diagnosis was benign neurinoma. Both eosinophilic cystitis and retroperitoneal neurinoma are rare, and the concurrent occurrence of these two diseases has not been reported. Recent studies have suggested that eosinophilic cystitis may occur more frequently than suspected, and may be overlooked clinically and microscopically. This uncommon form of cystitis should be considered in the differential diagnosis especially when the patient has unexplained episodes of bladder symptoms and hematuria.
一位63岁女性前来我院就诊,主诉排尿疼痛。她曾有过几次尿潜血发作。尿液分析显示有少量红细胞、白细胞和杆菌。体格检查发现其右侧腰部有一个拳头大小的肿块。膀胱镜检查显示为葡萄状肿瘤,有多个红斑性隆起斑块。活检报告显示膀胱黏膜下层有大量嗜酸性粒细胞浸润,即嗜酸性膀胱炎。抗生素在一周内有效改善了尿液检查结果和症状。静脉肾盂造影(IVP)和计算机断层扫描(CT)显示腹部肿块为伴有囊性变的腹膜后肿瘤,该肿瘤被切除。病理诊断为良性神经鞘瘤。嗜酸性膀胱炎和腹膜后神经鞘瘤均较为罕见,这两种疾病同时发生尚未见报道。近期研究表明,嗜酸性膀胱炎的发生频率可能比预期更高,在临床和显微镜检查中可能被忽视。在鉴别诊断时应考虑这种不常见的膀胱炎形式,尤其是当患者出现无法解释的膀胱症状和血尿发作时。