Macroscopic Hematuria and a Bladder Mass: Eosinophilic Cystitis in a 7-Year-Old Boy

Area of Science:

• Pediatric Urology
• Radiology
• Pathology

Background:

• Eosinophilic cystitis is a rare, benign inflammatory condition affecting the bladder.
• It is often associated with a history of atopic symptoms in children.
• Clinical presentation can include hematuria and dysuria, mimicking other bladder pathologies.

Purpose of the Study:

• To highlight the radiological findings in a pediatric case of eosinophilic cystitis.
• To evaluate the utility of different imaging modalities in diagnosing eosinophilic cystitis.
• To emphasize the importance of considering eosinophilic cystitis in the differential diagnosis of bladder masses in children.

Main Methods:

• Case report of a 7-year-old boy with eosinophilic cystitis.
• Review of imaging studies including ultrasonography (US) and CT urography.
• Histopathological confirmation via biopsy.

Main Results:

• Ultrasonography demonstrated irregular bladder wall thickening, suggestive of a mass.
• CT urography did not further characterize the lesion or reveal local/distant spread.
• Biopsy confirmed eosinophilic cystitis; US proved effective in lesion characterization.
• MRI is recommended over CT for staging prior to biopsy.

Conclusions:

• Ultrasonography is a safe, cost-effective, and primary imaging choice for evaluating suspected eosinophilic cystitis in children.
• Radiological findings alone are not specific for eosinophilic cystitis, necessitating clinical correlation and biopsy.
• Eosinophilic cystitis is a relevant, though rare, differential diagnosis for bladder masses in children, particularly those with an atopic history.