Localized amyloidosis of the ureter: a case report

A 46-year-old female was referred to our hospital with a complaint of left flank pain. Ultrasongraphy and computed tomography demonstrated a left hydronephroureter due to stenosis with a ureteral mass in the left lower ureter. Retrograde pyelography revealed severe stricture of left lower ureter and brushing cytology showed papanicolaou class III. Ureteral tumor was suspected and left nephroureterectomy with partial cystectomy was performed. Histopathological diagnosis was amyloidosis of the left ureter. There was no evidence of secondary or systemic amyloidosis. Finally, we diagnosed her with localized amyloidosis of the left ureter. Localized amyloidosis of the ureter is a relatively rare condition, and this is the 55th case reported in the Japanese literature.     

Localized amyloidosis of the ureter: report of a case

A case of primary amyloidosis of the ureter is presented. The patient was a 48-year-old woman with a 5-year history of asymptomatic macrohematuria. Roentgenographic examination showed left hydronephrosis and stenosis of the left distal ureter. Histological examination of the biopsied specimen during the operation revealed no malignancy; and, left partial ureterectomy and uretero- vesiconeostomy was performed. Congo red stain proved amyloid deposition after surgery. Rectal biopsy was negative for amyloid; and, other laboratory findings were within normal range. Thus it was diagnosed as a primary localized amyloidosis of the ureter. Importance of intraoperative histologic examination was discussed. This is the 22nd case in the literature.     

Localized pleural amyloidosis: report of a case

We herein describe an asymptomatic 31-year-old male who was admitted for an investigation of an abnormal pleural tumor detected by chest radiography. We performed various preoperative investigations including fluorodeoxyglucose-positron emission tomography. The maximum standardized uptake value (SUVmax) was 2.2, and malignancy could not be ruled out. We therefore carried out a thoracoscopy-assisted partial resection of the right upper lobe combined with a parietal pleurectomy. The pathological examination showed that there was a tumor localized with pleural amyloidosis.     

Localized amyloidosis of the urinary bladder: a case report

Amyloidosis is characterized by extracellular deposition of abnormal insoluble fibrils, which cause structural and functional disorders. Amyloidosis is classified into systemic and localized amyloidosis. Localized amyloidosis in individual organs is uncommon. We report a rare case of localized form of primary amyloidosis of the urinary bladder. A 76-year-old male visited our hospital with a complaint of macroscopic hematuria. Cystoscopy showed submucosal hematoma in the anterior wall and broad-based mass occupying the trigone without normal mucosa covered by calcification. Transurethral biopsy and resection were performed. Histopathological diagnosis was AL type amyloidosis occupying submucosal extracellular space. We gave the patient occlusive dressing with dimethyl sulfoxide. In 12 months, cystoscopy and magnetic resonance imaging revealed improvement of the mass-like lesion in the bladder wall.     

Localized amyloidosis of the seminal vesicle: a case report

Primary amyloidosis of the seminal vesicle is a rare disease entity. We report here a case of localized seminal vesicle amyloidosis with hematospermia. A 66-year-old man visited our hospital with a chief complaint of hematospermia. T2 weighted magnetic resonance imaging (MRI) showed a hypointensity mass in the left seminal vesicle. Needle biopsy revealed amyloidosis of the seminal vesicle. Without any specific treatment, the mass lesion disappeared on MRI, and hematospermia was improved.     

Localized amyloidosis of urinary bladder: a case report

A case of localized amyloidosis of the urinary bladder is reported. A 82-year-old woman visited our hospital with the chief complaint of miction pain and residual urine sensation. Cystoscopic examination revealed a broad-based and nonpapillary tumor without bleeding on the right lateral wall. A transurethral biopsy of this tumor was performed. A histopathological examination with H.E. and Congo red stains demonstrated amyloid deposition in the submucosal layers of the vesical wall. Rectal biopsy and other findings suggested no deposition of amyloid in other organs. On the basis of these findings, we made a diagnosis of localized amyloidosis of the urinary bladder. To the best of our knowledge, the present case is the 23rd of localized amyloidosis of urinary bladder in Japan. The patient was asymptomatic after biopsy. We discuss the clinical features and management of this disease.     

Case report: a case of localized amyloidosis of the ureter

A 78-year-old man visited our hospital with a chief complaint ofmacrohematuria in January 2006. Ultrasonography and computed tomography showed left hydronephroureter due to the enhanced tumor which was 10 mm in diameter in the lower ureter. Urine cytology was Class II. Retrograde pyelography could not be performed because of severe pain and hematuria. We considered the possibility of the malignant neoplasm and performed left total ureteronephrectomy in March 2007. The mucosa of the ureter was thickened and sclerosed. Microscopic appearance of the surgical specimen shows non-structural fibrosis and stained red with Congo-red stain. So amyloidosis of the ureter was suspected. After the systemic examination, the diagnosis was localized amyloidosis of the ureter. After 8 months, recurrence has not been pointed out.     

Localized nodular pulmonary amyloidosis; report of a case

A 66-year-old female was admitted to our hospital because of chest abnormal shadow. Chest X-ray and chest computed tomography (CT) on admission showed a nodule in the right middle lobe. The nodule was not diagnosed preoperatively by a bronchoscopy. She underwent partial lung resection including the nodule with video-assisted thoracoscopic surgery. The pathological diagnosis was amyloidosis, and we diagnosed her illness as localized nodular pulmonary amyloidosis, since the amyloid substance was type AL. In addition, electron microscopy showed amyloid as straightly fibrous materials in alveolus. It is difficult to differentiate amyloidosis from lung cancer by radiology, and the lung biopsy with video-assisted thoracoscopic surgery is useful and a safety way to establish diagnosis.     

Unilateral extended amyloidosis of the renal pelvis and ureter: a case report

Localized amyloidosis of the genitourinary tract is a rare phenomenon. The differential diagnosis between amyloidosis and malignancy is difficult. We report the case of an 81-year-old man with extensive unilateral localized amyloidosis of the renal pelvis, ureter and ureteral orifice. Diagnosis of amyloidosis was confirmed only postoperatively.     

Localized amyloidosis of the ureter and bladder treated effectively by occlusive dressing technique therapy using dimethyl sulfoxide: a case report

We report here the first case of localized amyloidosis of the ureter and bladder to be treated effectively by occlusive dressing technique therapy using dimethyl sulfoxide. The patient was a 48-year-old woman whose chief complaint was macrohematuria and right back pain. Ultrasound sonography demonstrated right hydronephrosis and an intravesical mass in the region of the right ureteral orifice. Retrograde pyelography revealed severe stricture of the right lower ureter. Cystoscopy demonstrated a yellow submucosal tumor around the right ureteral orifice. We suspected urinary tract amyloidosis, and transurethral biopsy and resection of the intravesical mass were performed under right ureteral stenting. Histopathological diagnosis was amyloidosis. There was no evidence of systemic amyloidosis. To treat residual amyloidosis of the ureter and bladder, we performed occlusive dressing technique therapy using dimethyl sulfoxide every day. After 6 months of therapy, the right hydronephrosis disappeared, and there was no evidence of a recurrence of amyloidosis. We concluded that this therapy was very effective and safe for urinary tract amyloidosis.     

局限性膀胱淀粉样变1例报告并文献复习

目的:探讨局限性膀胱淀粉样变病因、临床表现、影像学诊断方法、病理特征及诊疗方法。方法:回顾分析1例局限性膀胱淀粉样变患者的临床资料,总结复习相关文献。结果:患者经抗感染、止血、对症治疗,效果较好,随访7个月未复发血尿。结论:膀胱淀粉样变为少见病,主要表现为无痛性肉眼血尿,膀胱侧壁和三角区为好发部位,确诊主要依靠膀胱镜下活检,病理学检查刚果红染色后偏振光显微镜下呈现出苹果绿色双折射光。治疗以手术切除为主,术后辅以二甲基亚砜膀胱灌注,疗效及预后良好。     

Blind-ending bifid ureter: a case report

This is a report on a case of blind-ending ureter. The patient was a 56-year-old female who had complained of a pain in the left flank. There was no urinary tract infection. Excretory urography revealed a left blind-ending bifid ureter. It was resected and the removed specimen was about 8 cm in length. Histologically, it had all layers of the ureteral structure, but no renal tissue was found. The post-operative course was uneventful. We collected 55 cases of blind-ending bifid ureters reported in Japan including our own and discussed the difference between blind-ending bifid ureter and ureteral diverticulum.