Giant cell cystitis

Giant cell cystitis is term used for a benign change of mesenchymal cells in the urinary bladder lamina propria.

Giant cell cystitis is considered a misnomer as it may be seen in an otherwise normal bladder that lacks significant inflammation.

General

• Considered a common benign finding; not a clinical entity.
• Reported in up to 1/3 of bladders at autopsy.

Microscopic

Features:

• Scattered atypical mesenchymal cells - mononuclear or multinucleated - key feature.
• +/-Nuclear hyperchromasia and/or lobulation.
• Minimal/absence of mitotic activity.

Note:

• Inflammation may be present or absent; "giant cell cystitis" is a misnomer.

DDx:

• Radiation cystitis - history of radiation, more atypical usually with nucleoli.
• Sarcoma of the bladder or metastatic sarcoma - typically more cellular.
• Sarcomatoid change in urothelial carcinoma.

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Urinary Bladder, Biopsy:
- Urothelial mucosa with scattered large atypical mesenchymal cells in the 
  lamina propria, prominent smooth muscle and prominent superficial 
  blood vessels.
- Urothelium within normal limits.
- Thick benign muscularis propria.
- NEGATIVE for significant proliferative activity and NEGATIVE for significant inflammation.
- NEGATIVE for dysplasia and NEGATIVE for malignancy.

See also

• Radiation cystitis.