Case Study

Lymphoplasmacytic interstitial cystitis suspected in a 3 year old FS DSH cat with persistent bladder wall thickening

A 3-year-old SF DSH was presented for evaluation of stranguria and inappropriate urination.

Image Interpretation

The urinary bladder presented persistent concentric wall thickening with adhered mucous and sand debris. No significant improvement has been noted from the prior sonogram.
The kidneys revealed normal size and structure, corticomedullary definition and ratio for this age patient. The cortices presented largely uniform texture with normal echogenic relationship to liver and spleen. Medullary echogenicity differed distinctly from that of the cortex. The capsules were acceptably uniform without dramatic irregularities. Slight mineralization was noted in the left kidney along with slight pyelectasia that measured 0.17 cm. The left kidney measured 3.78 cm. The right kidney measured 3.79 cm.

DX

lymphoplasmacytic interstitial cystitis vs bladder lymphoma

Outcome

Cystotomy is strongly recommended in this patient with the objective of evacuating the bladder from any sandy material with culture and biopsies of the bladder wall. The wall thickening is largely concentric and more dramatic in the ventral apical aspect. Inflammatory cell type will help to direct therapy in this patient especially if this a lymphoplasmacytic interstitial cystitis. There is a minor potential for bladder lymphoma as well as chronic bacterial cystitis, less likely.