PMC9807346_01
Cystoscopic images taken during a biopsy for diagnostic assessment: (a) Ulcerated pseudopolypoid lesion on the bottom of the bladder; (b) endoscopic biopsy of the postero-lateral wall of the urinary bladder; (c) resection bed: normal tissue layers are not visible.
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Cystoscopy showed inflammation of the mucosa and an ulcerated pseudopolypoid lesion on the bottom of the bladder (Fig. 1).
Biopsy of the posterior wall of the urinary bladder, compatible with the diagnosis of HE. (a) Severe inflammation extended to the muscular layer; (b) occasional multinucleated giant cells and foci of necrosis (hematoxylin-eosin x100); (c) eosinophilic infiltrate (Hematoxylin-eosin x400); (d) numerous eosinophils in chorion (Giemsa x400).
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The histological examination (Fig. 2) revealed a rich eosinophilic-giant cell lympho-granulocyte infiltrate with granulomatous aspects and some necrotic focus, in the absence of peripheral hypereosinophilia.
(a) Uro-CT showing hypervascularization around the bladder, thickening of posterolateral wall, an effusion due to vesical rupture in the anterolateral wall and enlargement of locoregional lymph nodes; (b) chart diagram with time showing the clinical course with symptoms, exams, and therapies.
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Triphasic contrast CT highlighted flogosis of the maxillary sinuses and low-capacity urinary bladder with thickening of the posterolateral wall and an effusion nearby the resection area (Fig. 3).