Primary Amyloidosis of the Urinary Bladder
Amyloidosis is a systemic disease that usually occurs in the gastrointestinal tract or in muscular or adipose tissue. Primary amyloidosis of the urinary bladder is a rare disease that can mimic bladder cancer on cystoscopic examination as well as in its clinical presentation of painless gross hematu...
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doaj-397da277ffce45319faefb87cee8d1592020-11-24T23:50:55ZengElsevierJournal of the Formosan Medical Association0929-66462006-01-01105216416710.1016/S0929-6646(09)60339-9Primary Amyloidosis of the Urinary BladderChao-Yuan HuangKuo-How HuangJun ChenYeong-Shiau PuAmyloidosis is a systemic disease that usually occurs in the gastrointestinal tract or in muscular or adipose tissue. Primary amyloidosis of the urinary bladder is a rare disease that can mimic bladder cancer on cystoscopic examination as well as in its clinical presentation of painless gross hematuria. This report describes a 49-year-old male with repeated painless gross hematuria, who underwent transurethral resection of a suspected bladder tumor. Pathologic examination revealed papillary urothelial hyperplasia with vascular ectasia and no signs of malignancy. Massive gross hematuria occurred 2.5 years later. Cystoscopy showed multiple papillary lesions with yellowish-brown submucosal plaques on the posterior bladder wall. A second transurethral tumor resection was performed and histologic examination revealed plasma cell infiltration and eosinophilic amorphous deposits in the subepithelial stroma and vascular wall. The deposits were positive for Congo red and apple-green birefringence under polarized light examination but negative for Masson's trichrome stain, indicating that they were not fibrotic in nature. Hence, the diagnosis of amyloidosis of the urinary bladder was confirmed. Screening for amyloidosis was negative in other organ systems and the patient has remained disease-free up to the last follow-up 4 years after the second transurethral resection. Amyloidosis should be considered in the differential diagnosis of patients with recurrent hematuria who have symptoms characteristic of bladder cancer but negative pathologic study for malignancy. Correct diagnosis relies on clinical alertness and the use of a special staining technique during pathologic examination.http://www.sciencedirect.com/science/article/pii/S0929664609603399amyloidhematuriaurothelial carcinoma |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chao-Yuan Huang Kuo-How Huang Jun Chen Yeong-Shiau Pu |
spellingShingle |
Chao-Yuan Huang Kuo-How Huang Jun Chen Yeong-Shiau Pu Primary Amyloidosis of the Urinary Bladder Journal of the Formosan Medical Association amyloid hematuria urothelial carcinoma |
author_facet |
Chao-Yuan Huang Kuo-How Huang Jun Chen Yeong-Shiau Pu |
author_sort |
Chao-Yuan Huang |
title |
Primary Amyloidosis of the Urinary Bladder |
title_short |
Primary Amyloidosis of the Urinary Bladder |
title_full |
Primary Amyloidosis of the Urinary Bladder |
title_fullStr |
Primary Amyloidosis of the Urinary Bladder |
title_full_unstemmed |
Primary Amyloidosis of the Urinary Bladder |
title_sort |
primary amyloidosis of the urinary bladder |
publisher |
Elsevier |
series |
Journal of the Formosan Medical Association |
issn |
0929-6646 |
publishDate |
2006-01-01 |
description |
Amyloidosis is a systemic disease that usually occurs in the gastrointestinal tract or in muscular or adipose tissue. Primary amyloidosis of the urinary bladder is a rare disease that can mimic bladder cancer on cystoscopic examination as well as in its clinical presentation of painless gross hematuria. This report describes a 49-year-old male with repeated painless gross hematuria, who underwent transurethral resection of a suspected bladder tumor. Pathologic examination revealed papillary urothelial hyperplasia with vascular ectasia and no signs of malignancy. Massive gross hematuria occurred 2.5 years later. Cystoscopy showed multiple papillary lesions with yellowish-brown submucosal plaques on the posterior bladder wall. A second transurethral tumor resection was performed and histologic examination revealed plasma cell infiltration and eosinophilic amorphous deposits in the subepithelial stroma and vascular wall. The deposits were positive for Congo red and apple-green birefringence under polarized light examination but negative for Masson's trichrome stain, indicating that they were not fibrotic in nature. Hence, the diagnosis of amyloidosis of the urinary bladder was confirmed. Screening for amyloidosis was negative in other organ systems and the patient has remained disease-free up to the last follow-up 4 years after the second transurethral resection. Amyloidosis should be considered in the differential diagnosis of patients with recurrent hematuria who have symptoms characteristic of bladder cancer but negative pathologic study for malignancy. Correct diagnosis relies on clinical alertness and the use of a special staining technique during pathologic examination. |
topic |
amyloid hematuria urothelial carcinoma |
url |
http://www.sciencedirect.com/science/article/pii/S0929664609603399 |
work_keys_str_mv |
AT chaoyuanhuang primaryamyloidosisoftheurinarybladder AT kuohowhuang primaryamyloidosisoftheurinarybladder AT junchen primaryamyloidosisoftheurinarybladder AT yeongshiaupu primaryamyloidosisoftheurinarybladder |
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