Eosinophilic Cystitis Mimicking Malignancy on FDG PET/CT

Area of Science:

• Urology
• Pathology
• Radiology

Background:

• Eosinophilic cystitis is a rare, benign bladder inflammation.
• It can present with symptoms mimicking bladder cancer, such as dysuria and nocturia.
• Advanced imaging modalities like MRI, CT, and PET/CT are often used for diagnosis.

Observation:

• A 64-year-old male presented with a one-month history of progressive dysuria and nocturia.
• Initial MRI and CT showed localized bladder wall thickening with significant enhancement.
• Delayed PET/CT revealed intense fluorodeoxyglucose (FDG) accumulation in the lesion.

Findings:

• Radiological findings suggested a suspected malignancy.
• Pathological examination ultimately confirmed the diagnosis of eosinophilic cystitis.
• This underscores the potential for imaging overlap between eosinophilic cystitis and bladder cancer.

Implications:

• Accurate diagnosis of eosinophilic cystitis is crucial to avoid unnecessary radical treatments for presumed malignancy.
• Pathological evaluation remains the gold standard for differentiating eosinophilic cystitis from bladder cancer.
• Awareness of this differential diagnosis is important for urologists and radiologists.