Fig 1.
(A) Quantification of CD3-positive cells. CD3 immunostaining (left) and identification of CD3-positive cells by image analysis software (right). (B) Evaluation of epithelium/specimen ratio. Measurement of specimen area, circled in orange (left), and identification and measurement of cytokeratin-positive area (right).
Table 1.
Clinical features of patients with interstitial cystitis (IC).
Fig 2.
Representative histology of non-Hunner-type interstitial cystitis (NHIC) biopsy specimen.
(A) low-power view reveals unremarkable bladder mucosa; (B) overlying epithelium is well preserved; no stromal inflammation is seen; (C) lymphocytes are only occasionally found in the lamina propria. (D–F) Representative histology of the HIC biopsy specimen taken from background (non-Hunner lesion) mucosa (HIC-BG): (D) diffuse inflammatory cell infiltration with focal aggregate of lymphocytes present in the subepithelial layer; (E) dense subepithelial inflammation observed in a linear pattern; (F) inflammatory cells predominantly composed of lymphocytes and plasma cells; epithelium is irregularly denuded. (G–I) Representative histology of the Hunner lesions of patients with HIC: (G) low-power view; (H) subepithelial layer diffusely inflamed; (I) epithelium completely denuded and numerous plasma cells found in the underlying stroma.
Table 2.
Semi-quantitative analysis of pathological features of interstitial cystitis (IC) biopsy specimens.
Fig 3.
Evaluation of inflammatory cell infiltration and residual epithelium by image analysis software.
(A) Lymphoplasmacytic infiltration in non-Hunner-type interstitial cystitis (NHIC), HIC-BG (background mucosa), HIC-HL (Hunner lesion) and non-IC cystitis specimens. Lateral bars indicate the means. Lymphoplasmacytic infiltration was much more severe in HIC-BG and HIC-HL than NHIC. The number of infiltrating mononuclear cells in NHIC specimens was very few (<200 cells/mm2) in most cases. The non-IC cystitis group showed a similar degree of mononuclear cell inflammation to that of HIC-BG and HIC-HL. (B) Plasma cell ratio in NHIC, HIC-BG, HIC-HL and non-IC cystitis specimens. This was significantly higher in HIC-HL and HIC-BG than in NHIC and non-IC cystitis. (C) Epithelium/specimen ratio in NHIC, HIC-BG, HIC-HL and non-IC cystitis specimens. Lateral bars indicate the means. The epithelium/specimen ratio is significantly lower in HIC specimens compared with NHIC and non-IC cystitis specimens (P <0.0001).
Fig 4.
Inflammation and epithelial denudation in HIC cases.
(A) Each case of Hunner-type/classic IC (HIC) was plotted for lymphoplasmacytic infiltration in Hunner lesion (HIC-HL) and background mucosa (HIC-BG) (n = 27). There was no significant correlation between the degree of inflammation in HIC-HL and that in HIC-BG. In 18 of 27 cases, lymphoplasmacytic infiltration was denser in HLs than in the BG. (B) Each case of HIC was plotted for the epithelium/specimen ratio of HIC-HL and HIC-BG (n = 27). There was no significant correlation between the degree of epithelial loss in HIC-HL and that in HIC-BG. In 19 of 27 cases, the epithelium/specimen ratio was lower in HLs than in the BG.
Table 3.
Correlation between lymphoplasmacytic infiltration measured by image analysis and semi-quantitative inflammation grading in interstitial cystitis (IC) biopsy specimens.
Fig 5.
Correlation between lymphoplasmacytic infiltration and epithelium/specimen ratio in Hunner-type/classic IC specimens.
Degree of lymphoplasmacytic infiltration did not correlate with the amount of residual epithelium.
Fig 6.
Hunner-type/classic IC (HIC) specimen with expansion of light chain-restricted B cells (κ >>> λ).
(A) A dense plasmacytic infiltration is observed in the subepithelial stroma. (B) In situ hybridization for the κ chain reveals numerous κ-positive cells. (C) In situ hybridization for the λ chain reveals only a few λ-positive cells.
Table 4.
Light-chain restriction in cases of Hunner-type interstitial cystitis (HIC).