Question

What is the likely diagnosis in a case with renal calcification, irregular bladder wall outline, and hematuria?

• A. Tuberculosis
• B. Schistosomiasis
• C. Amyloidosis
• D. Hunner's cystitis

Hint:

Chronic parasitic egg deposits in the bladder wall cause calcification and hematuria over years.

Answer 1

The Correct Option is B

Step 1: Understanding the Question:
The findings given are calcification in the renal tract, an irregular outline of the bladder wall, and blood in the urine. We need the disease that produces this triad.

Step 2: Key Concept:
Urinary schistosomiasis (bilharzia), caused by Schistosoma haematobium, is a parasitic infection that deposits calcified eggs in the wall of the bladder and lower ureters. Over years this produces patchy calcification, a thickened and irregular bladder wall, and chronic hematuria (blood in urine) from mucosal ulceration.

Step 3: Detailed Explanation:
On imaging, chronic schistosomiasis gives a classic "calcified bladder" sign, a fine rim of calcium outlining an irregular, sometimes contracted bladder, plus calcification that can extend up the ureters and into the kidney collecting system. Hematuria is a very common early symptom, caused by the eggs eroding through the bladder mucosa.
Renal or urinary tuberculosis also causes calcification and hematuria, but the bladder change in TB is usually a small, thick walled, contracted "thimble bladder" rather than the fine eggshell calcification of schistosomiasis, and TB more often shows calyceal or ureteric strictures.
Amyloidosis of the urinary tract does not typically calcify the bladder wall in this pattern.
Hunner's cystitis (interstitial cystitis) causes bladder ulcers and pain but not this kind of calcification.

Step 4: Final Answer:
The combination of renal and bladder calcification with an irregular bladder outline and hematuria is the classic picture of urinary schistosomiasis.