American Urological Association - Interstitial Cystitis
- Chronic inflammatory process of the bladder of unknown etiology with protracted exacerbations.
- Much more common in women (90%) between 30's to 50's.
- Presents with constellation of symptoms including urinary frequency, urgency, suprapubic pressure, and bladder or pelvic pains.
- Clinical diagnosis of exclusion: must have negative culture studies, no inciting irritating agents to bladder and without bladder neoplasia.
- Reddened mucosa with ulcer containing blood vessels radiating towards a central scar
- In non-ulcerative form, exhibits petechia and submucosal hemorrhages (glomerulations) or linear cracks after bladder distention.
- Histology: No pathognomonic histologic features; role of pathologists is to exclude neoplasms and other known causes of cystitis.
- Ulceration with inflammatory infiltrates composed mostly of neutrophils and granulation tissue
- Perineural lymphocytic infiltration (perineuritis) common.
- In non-ulcerative form, exhibits mucosal hemorrhages and epithelial ruptures.
- May see increased mast cell infiltrates that can be highlighted by toluidine blue, however, is not a specific feature (image B, arrows).