1988 Volume 79 Issue 11 Pages 1848-1851
A 54-year-old man was hospitalized with a chief complaint of voiding pain. The patient was treated with transurethral resection of the papillary bladder tumors. The histopathological diagnosis was transitional cell carcinoma, G2, pTa. Urinary cytology was still positive after transurethral resection. Cold cup biopsies showed carcinoma in situ of the bladder. He was given 80mg BCG intravesical instillations every week for six weeks. Both urinary cytology and cold cup biopsies became negative after intravesical BCG treatment. Three weeks after initiating BCG treatment, the patient began to complain of gross hematuria, frequency, urgency and pain on urination. The irritative voiding symptoms did not respond to conservative therapy and bladder capacity was reduced to 50ml. Total cystectomy and construction of an ileal conduit were performed 7 months after BCG treatment. The bladder mucosa was edematous with areas of superficial hemorrhagic changes. The surface epithelium was denuded and no tumor cells were noted. Tuberculous inflammatory changes with caseous necrosis, lymphocyte infiltration and giant cells were found in submucosa of the bladder.
