Pediatric Cyclophosphamide Induced Cystitis

Etiology: Seen in 70% of patients given high doses of cyclophsphamide
Imaging:
— Diffuse bladder wall thickening with hyperemia
— Debris and clots in bladder
DDX:
Complications:
Treatment:
Clinical: Severe hemorrhagic cystitis

Radiology Cases of Cyclophosphamide Induced Cystitis

CT of cyclophosphamide induced cystitis — Axial (above), coronal (below left) and sagittal (below right) CT with contrast of the abdomen shows diffuse thickening of the bladder wall and hyperemia of the bladder mucosa.

Transverse (above) and sagittal (below) US of the pelvis shows an extremely thick-walled bladder containing echogenic debris and clots.

CT of cyclophosphamide induced cystitis with a large blood clot in the bladder — Axial CT with contrast of the pelvis (above) shows mild thickening of the wall of the bladder which has a large oval mass within it that has a whorled appearance. Transverse US of the bladder (below) shows a large round echogenic lesion with a whorled appearance located posteriorly in the bladder.