1. How do you confirm itâ€™s primary bladder amylodisis ?
Nitesh has posted a case of
Pr Amyloidosis of Urinary Tract Frequently
mimics Neoplasia. Within
the genitourinary system, the Prostate and Seminal Vesicles are most commonly
involved by localized amyloidosis and are usuÂally asymptomatic incidental
findings in prosÂtate specimens. Localized Urinary Tract AmyÂloidosis (UTA)
other than prostate and seminal vesicles is very rare and is of interest to
physiÂcians of various specialties, including radioloÂgists, urologists and
pathologists, because it mimics urothelial cell carcinoma clinically, cysÂtoscopically,
and radiologically. Though there are several reports published, most are case
Reports with few being case series.
The amyloid was first described by Virchow
in 1854. The first case of isolated urinary bladder amyloidosis was described
by Solomin in 1897. There are ~200 cases reported in the literature.
Oltita Tirzaman et al (2000, Mayo Clinic Proceedings) have analyzed 31
Cases of Pr Localized Amyloidosis of Urinary Bladder (probably the largest
series till to date), found Multiple Bladder areas were involved
in 65%, a single area was involved in 26%, and diffuse involvement was present
in 10%. Amyloid
deposition is found predominantly in the posterior bladder wall (68%), followed
by in the trigone (26%).
Majority of patients had immunoglobulin light chain, and 3 had Transthyretin-related
amyloid. Local Recurrences were common making Cystoscopic follow ups necessary.
However, repeated work-ups for systemic amyloidosis are unnecessary for
patients with light chain related amyloidosis of the urinary bladder.
I am providing Few Links from which more information on
Amyloidosis of Urinary Bladder can be had.
Though a rare condition, it
is often mistaken for Urothelial Neoplasia and Immunohistochemistry is often
needed to arrive at a diagnosis
With Warm Regards,
Thank you sir for your expert comments, few things I would like add about amylodosis are