Despite much research on FUS, there still is no consensus regarding its cause, or even its definition. We recently have demonstrated that some cases of FUS are similar to interstitial cystitis in human beings. Exclusion of anatomic defects, behavior abnormalities, neoplasia, urolithiasis, urethral obstruction, and urinary tract infection leads one to the diagnosis of interstitial cystitis in cats. This diagnosis suggests the need for new approaches to treatment, including pain management and environmental modification.

Interstitial cystitis in cats

Companion animal diets may be related to prevention, pathogenesis and/or treatment of diseases of the lower urinary tract. For example, urolithiasis can be either diet induced or nutrient sensitive. One of the most interesting developments in veterinary urolithiasis research has been the recent change in the composition of stones recovered from cats. In 1984, 88% of stones analyzed by quantitative methods were > 70% struvite, whereas < 1% were calcium oxalate. In 1992, the percentage of struvite had dropped to 62, whereas the percentage of calcium oxalate had increased to 24. Another recent development in lower urinary tract disease of cats is the recognition that urolithiasis appears to be a minor cause of the signs of frequency, urgency and hematuria for which patients are presented. This suggests that diet may no longer be involved, or be involved in previously unrecognized ways, in many current cases of this disease. Some of these feline patients may have a disease similar to interstitial cystitis, a disease of humans that appears to be of neuroepithelial origin. Our laboratory has been studying this possibility recently, and many similarities between the two diseases have been found.

Lower Urinary Tract Disease in Cats—New Problems, New Paradigms

Scattered argyrophil cells were present in normal, large, medium-sized and small pancreatic ducts (ductules) There was marked increase in argyrophil cells in ducts with hyperplastic epithelium Argyrophil cells were also found in 677% of all exocrine pancreatic carcinomas In a well differentiated group including cystadenocarcinoma, mucinous carcinoma and well differentiated ductal adenocarcinoma argyrophil cells were found in all cases examined Using four antisera (against insulin, glucagon, somatostatin and gastrin), insulin, glucagon and somatostatin cells were identified in 265%, 0001% and 12% of normal ducts, and 75%, 24% and 46% of ducts with hyperplastic epithelium respectively and were also greatly increased in numbers in the latter group Immunoreactive cells were present in 667% of exocrine carcinomas Cells reactive for insulin were found in 7/15 cases; glucagon in 6/15 cases; somatostatin in 5/15 cases and gastrin in 2/15 cases Eight cases contained two or more than two types of immunoreactive cells The presence of argyrophil and hormone immunoreactive cells in pancreatic ducts and carcinomas is indicative of the close developmental relationship between endocrine and exocrine parts of the pancreas The inter-relationship of response in the different cell types following stimulus suggests that injury to a common precursor may be involved

Argyrophilic and hormone immunoreactive cells in normal and hyperplastic pancreatic ducts and exocrine pancreatic carcinoma

Primary carcinoid tumor of the urinary bladder is a very rare neoplasm. We report here a case of primary carcinoid tumor of the urinary bladder with an unusual cytological feature in a 72-year-old Japanese man. A bladder polypoid mass was incidentally found by ultrasonography during the follow-up of a benign prostate hyperplasia. Histological examination of the transurethrally resected tissue revealed that the upper part of the mass was a tumor showing tubuloglandular anastomosing structures. Most of the tumor cells had peculiar subnuclear eosinophilic granules. The features of the granules were reminiscent of those observed in neuroendocrine cells of the intestine. The tumor cells were immunohistochemically positive for chromogranin A and synaptophysin. The tumor was diagnosed as carcinoid tumor of pure form of the urinary bladder. The lower part of the mass showed the findings of glandular cystitis, as its coexistence with carcinoid tumors of the bladder has often been described in previous reports.

Primary carcinoid tumor of the urinary bladder with prominent subnuclear eosinophilic granules.

Carcinoid tumors are well documented in the pulmonary and gastrointestinal systems, but very rare in the urinary tract, especially in the renal pelvis. We report on a 60-year-old female patient who presented with left flank pain and fever. Abdominal computed tomography demonstrated a heterogeneously enhancing mass in the left renal pelvis and a stone at the left proximal ureter. Multiple parenchymal lesions were also observed, which were identified as uneven caliectasis displaying air-fluid levels and renal parenchymal atrophy. The patient underwent simple nephro-ureterectomy. Macroscopically, a polypoid mass was observed in the renal pelvis. Microscopically, the tumor revealed acinar, tubular, and solid pattern and was composed of small, monotonous and hyperchromatic cells. Lining epithelia in renal pelvis and ureter revealed columnar epithelia with dysplastic change. The tumor cells were positive for chromogranin A, synaptophysin, CD56, and focally positive for cytokeratin. Immunohistochemical staining of synaptophysin and chromogranin A highlighted the neuroendocrine cells in the columnar epithelium. Ki-67 (1:50; MIB-1) labeling index was less than 1% in the area with highest uptake. We report here a case of carcinoid tumor of the renal pelvis that was associated with adjacent dysplastic columnar epithelium.

Carcinoid tumor associated with adjacent dysplastic columnar epithelium in the renal pelvis: A case report and literature review

Several types of metaplasia can occur in human bladder epithelium under certain pathological conditions. We investigated 65 cases of cystitis, associated with different types of metaplasia, for the presence of endocrine cells, using histochemical and immunocytochemical methods. Tissues were obtained at cystoscopy and were routinely fixed in 10% buffered formalin. Endocrine cells were demonstrated, between the epithelial cells, in 40 out of 50 cases of cystitis glandularis or cystica. These cells were positive by the Grimelius' silver impregnation technique and were immunoreactive for protein gene product (PGP 9.5), a new general neuroendocrine marker, chromogranin and serotonin. No endocrine cells were detected in any of the specimens of normal epithelium nor those showing squamous metaplasia. Eighteen of these cases showed prominent nerve bundles in the sub-epithelial tissue, as revealed by PGP immunoreactivity.

Endocrine differentiation in inflamed urinary bladder epithelium with metaplastic changes.

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Endocrine differentiation in inflamed urinary bladder epithelium with metaplastic changes.