原发性巨球蛋白血症合并银屑病与肾淀粉样变一例

银屑病先于原发性巨球蛋白血症发病已有报道，但尚未检索到后者先于前者发病的报道。我们最近遇到1例后一种组合且伴肾淀粉样变的患者。现报告如下。     

Obstruction of a ureter by isolated primary focal amyloidosis.

A rare case of obstruction of the pelvic segment of the ureter by an isolated focus of primary amyloidosis is described. The operation consisted of resection of the constricted segment of the ureter and end-to-end anastomosis, with very good early and late results. The differential diagnosis and therapy of this type of ureteral obstruction are discussed.     

A case of primary leiomyosarcoma of the ureter

A 60-year-old woman was admitted to our hospital with pain in the left flank. Retrograde pyelography, computed tomographic scan, and magnetic resonance imaging demonstrated left hydronephrosis due to a 7 cm retroperitoneal mass involving the left ureter. Left nephroureterectomy and partial resection of the mesentery revealed a primary ureteral leiomyosarcoma. Three months postoperatively, the patient received systemic chemotherapy (CYVADIC; cyclophosphamide, vincristine, adriamycin and DTIC) for a recurrent tumor. Two courses of chemotherapy reduced the tumor by nearly 60%. Then we performed surgery in an attempt to resect the residual disease. However, the tumor continued to progress and the patient died approximately one year after diagnosis.     

A case of primary leiomyoma of the ureter

This report describes a case of primary leiomyoma of the ureter in which only partial ureterectomy was performed based on the diagnosis of benign tumor by rapid diagnosis using a frozen section during the operation. Surgical treatment was opted for upon diagnosis of a submucosal tumor of the right ureter, with no abnormal findings in the ureteral mucosa by ureteroscopy. To our knowledge, nine cases have been reported worldwide since 1955, suggesting this case to be the 10th.     

Spontaneous rupture of the spleen caused by primary amyloidosis. Description of a clinical case

Spontaneous rupture of the spleen in primary amyloidosis is an uncommon event. After a review of the pertinent literature (10 case-reports between 1948 and 1987) a case of spontaneous splenic rupture with hemoperitoneum is presented. The diagnosis depends on the demonstration of amyloid deposit in splenic and hepatic tissues.     

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: a case report

A 58-year-old woman was introduced to our department complaining of lower abdominal pain and macrohematuria in March, 1978. Intravenous pyelography revealed stenosis and a ureteral stone on the right distal ureter. In May, 1983, she visited our department again. Endoscopically, bleeding from the right ureteral orifice was observed. Retrograde pyelography demonstrated the right hydronephrosis and irregular margin of the right lower ureter. However, the urine cytology was negative, and CT scan and ureteroscopy showed no tumorous lesion on the portion. On 7 August, 1989, partial ureterectomy and end to end anastomosis was performed. Histopathological examination by H-E and Congo red stain proved amyloid deposition. Postoperative course was uneventful. A total of 40 cases of amyloidosis of the ureter in the world are reviewed.     

A case of primary diffuse tracheobronchial amyloidosis

Tracheobronchial amyloidosis (TBA) is an uncommon localized form of amyloidosis with fewer than 150 reported cases in the literature. We report a case of primary diffuse tracheobronchial amyloidosis who presented with cough, wheezing, recurrent and progressive dyspnea as well as hemoptysis. Though there is no universally accepted treatment for the localized form, this patient was successfully treated with three sessions of bronchoscopic resection and adjuvant steroids. This report will review the various types of amyloidosis of the respiratory tract and their clinical features, in addition to discussing the different available treatment modalities for TBA.     

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.     

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.     

A case of primary localized amyloidosis of the urinary bladder

A case of primary localized amyloidosis is reported. The patient was a 73-year-old female who suffered from miction pain and consulted our department. There was a 1.5 x 1.5 cm slightly red, nonpapillary tumor around the right ureteral orifice in cystoscopy. The diagnosis was amyloidosis with cystitis hemorrhagica histopathologically. After the treatment with antibiotics for about one month there were no symptoms and no tumors in the urinary bladder cystoscopically. The clinical course was relatively good. The treatment varies from transurethral resection to total cystectomy with urinary diversion. This case was cured by non-operative treatment, but close follow-up of the patient is necessary because of the frequency of multiple recurrence.     

Primary amyloidosis of ureter

Another case of primary isolated amyloidosis of the ureter is reported; we believe this is the seventeenth such case reported in the world literature. The previous cases are reviewed, and the clinical presentation and treatment are discussed. The importance of distinguishing the condition from transitional cell carcinoma of the ureter is emphasized and a conservative approach to surgical treatment is advocated.     

Primary localized amyloidosis of the ureter

Primary amyloidosis is a rare condition that can involve the urinary tract. These lesions can occur anywhere in the collecting system and are often mistaken clinically for malignancies. We report a case of localized ureteral amyloidosis. Our treatment consisted of a conservative approach with local resection.     

A rare case of upper ureter rupture: ureteral perforation caused by urinary retention

Perforation of the ureter is a rare condition that causes a series of problems including retroperitoneal urinoma, urosepsis, abscess formation, infection, and subsequent renal impairment. There are causative factors that induce ureteric rupture, including malignancy, urinary calculi, idiopathic retroperitoneal fibrosis, recent iatrogenic manipulation, external trauma, degenerative kidney conditions, urography with external compression, and spontaneous causes. We report a rare case of ureteric rupture caused by urinary retention. The patient was treated with temporary percutaneous drainage and antibiotics. The present case illustrates that urinary retention can induce not only bladder rupture, but also ureteric rupture. It is thus of paramount importance to effectively manage patients with voiding problems.