Name of patient: xxx

          Pathologic Findings & Diagnosis   

Diagnostic conclusion (for the 1^st time): chronic cystitis

Double-checked the pathologic section of xxxx-xx and found that the wall of the small vessel on the bladder membrana propria thickens, indicating that vasculitis has changed. Inflammatory infiltration of the interstitial tissue is obvious; there are many oxyphil cells.  Based on the above changes, I assume that the symptom is resulted from the reaction of illness on connective tissue.    

Doctor: xxx

                        Date: August xx, xxxx

Sex: x        Age: x

Hospital

Name of department or ward:

Out-patient Department

Hospital bed No.

Outpatient or hospitalization No.:

Tissue sent for examination:

Doctor proposing the examination:

Date when the sample was tested:

(To be filled by the person sending the sample)

Name of patient: xxx

          Pathologic Findings & Diagnosis   

Diagnostic conclusion: polypous cystitis on the wall of bladder.

(There is sub inflammatory reaction close to the intramural area, some lymphocytic infiltration and dropsy; there is no fibroplasias, no obvious intramural inflammation, so the evidence for diagnostic conclusion of interstitial cystitis is not sufficient.)

Sex: x        Age: x

Hospital：The present hospital

Name of department or ward:

Urinary Surgical Department

Hospital bed No.

Outpatient or hospitalization No.:

Tissue sent for examination:

Doctor proposing the examination:

Date when the sample was tested:

(To be filled by the person sending the sample)