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| Mucosal Hemorrhage |
| Etiology |
•Trauma. •Infections, such as adenovirus infection in
immunocompromised patients (post bone marrow
transplantation). •Chemotherapeutic agents such as cyclophosphamide. |
| Pathogenesis |
•Direct physical trauma to the mucosa as in indwelling
catheters. •Toxic effect of chemotherapeutic agents upon the urothelium such as metabolites of cyclophosphamide excreted in the urine. |
| Epidemiology |
•See etiology. |
| Clinical |
•Mucosal hemorrhage occurs in a variety of
circumstances. •A common clinical situation is
catheterization. •Other causes would include infections and chemotherapy induced cystitis as in cyclophosphamide therapy. |
| General Gross Description |
•The bladder
mucosal surface is discolored dark red, brown to black depending on the
severity of the hemorrhage. •The affected regions are variable in extent from focal to diffuse. |
| General Micro Description |
•Light microscopic examination would show hemorrhage within the lamina
propria of the urothelial mucosa. •There may be associated denudation and
ulceration of the overlying urothelium. •Cases associated with cyclophosphamide and adenovirus infection would show urothelial cell nuclear abnormalities. |
| Reference |
•Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp.
995. •Murphy WM. Urologic Pathology. Philadelphia: Saunders, 1989. p.48 and 97.
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