Localized amyloidosis of the urinary tract: case series of nine patients

Urology
J L O MerrimenR Gupta

Abstract

To report 9 cases of primary localized amyloidosis of the urinary tract and correlate the pathologic findings with clinical and cystoscopic information. Patients diagnosed with amyloidosis of the ureters, urinary bladder, or urethra from 1976 to 2003 were identified. Their medical records were reviewed, and histochemical and immunoperoxidase stains were performed on the tissue. Eight cases of amyloidosis of the urinary bladder and one of the renal pelvis/ureter were identified. None of our cases showed evidence of systemic amyloidosis. Of the 8 patients with amyloidosis of the urinary bladder, 5 presented with gross hematuria and 1 with irritative bladder symptoms and 2 had amyloidosis detected during cystoscopic follow-up for urothelial carcinoma. The patient with amyloidosis of the renal pelvis/ureter presented with flank pain and gross hematuria. The clinical impression was malignancy in 75% of the bladder cases. Most patients with bladder involvement were treated with localized bladder resection; however, 1 patient required total cystectomy for symptom control. Of 5 patients with follow-up information, 2 developed recurrence. The pathologic assessment diagnosed amyloid deposits consistent with primary or AL type amyloid in ...Continue Reading

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