Electron microscopic study of hemorrhagic radiation cystitis

Lim, Yong Soo; Lee, Kang Hyun; Cho, Kyung Ja

Abstract

One of the most severe complications of pelvic irradiation is radiation-induced bladder injury such as hemorrhagic radiation cystitis. We performed microscopic examination in 36 cases with hemorrhagic radiation cystitis to evaluate the pathologic changes induced by radiation. Transurethral cystoscopic biopsy was performed in 36 cases with hemorrhagic radiation cystilis. Light microscopic examination was done in 36 cases and transmission electron microscopic examination was done in 16 cases. Light microscopy in transitional cell epithelium revealed ulceration and inflammatory cell infiltration in the basal area of ulceration. Light microscopy in lamina propria revealed hyalinization, edema, inflammarory cell infiltration, hemorrhage, telangiectasia and fibrinoid necrosis of endothelial cells. Transmission electron microscopy in stroma revealed increased cellularity in 14 cases, enlargement or ribroblast in 4 cases, dilatation of rough endoplasmic reticulum(RER) in 5 cases, and large nucleoli in 4 cases among 16 cases. Enlargemenr of endothelial cells was found in 10 cases and multiplication or vascular basal lamina around the capillaries was found in 8 cases among 13 cases. We believe this study would be helpful to develop adequate treatment modality for hemorrhagic radiation cystitis.