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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. |
| 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 Microscopic 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. |
| Clinical Correlation •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. |
| References •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. |
| Mucosal Hemorrhage |
| Synopsis by: Harold Yamase M.D. (T74000M37000)[241] |
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