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3.
Arch Esp Urol ; 67(4): 341-4, 2014 05.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-24892396

RESUMO

OBJECTIVE: Amyloidosis is a disease characterised by deposition of eosinophilic hyaline material in different tissues. Urinary bladder involvement is uncommon with less than 200 cases of the primary form published in the literature. We present a new case of primary AA type amyloidosis of the urinary bladder (typical of secondary forms). METHODS: A 66-year-old male was seen in the outpatient urology consultation with several-weeks history intermittent haematuria with decreased voiding urinary calibre. In addition, he had intense nocturia, 10-12 times per night, and occasional urgency. Physical examination of the abdomen and genitals was unremarkable. Urine sediment and blood tests were normal. Urine cytology studies were requested and revealed urothelial cells with no atypical cells and a moderate quantity of neutrophils and erythrocytes. Cystoscopy was performed and revealed yellowish erythematous lesions at the level of the vesicoureteric junction and the fundus. The lesions were biopsied. Pathology studies revealed urothelial mucosa with marked chronic inflammation and accumulations of amyloid-appearing hyaline material in the area of the vessels with green birefringence on polarised light. TUR of the bladder was later performed with the goal of completely resecting the lesion. The result of the pathology studies confirmed the biopsy findings and immunohistochemistry studies revealed AA type amyloid (typical of secondary forms). RESULTS: Two years after the intervention, the patient remains asymptomatic with normal endoscopic follow-up studies. CONCLUSIONS: Primary AA type amyloidosis of the bladder is a very uncommon pathology with few cases reported in the international urology literature. Nevertheless, we must keep it in mind in the differential diagnosis when faced with a patient with haematuria and/or persistent urinary symptoms.


Assuntos
Amiloidose/terapia , Doenças da Bexiga Urinária/terapia , Idoso , Amiloidose/patologia , Humanos , Amiloidose de Cadeia Leve de Imunoglobulina , Imuno-Histoquímica , Rim/patologia , Masculino , Doenças da Bexiga Urinária/patologia
4.
Arch. esp. urol. (Ed. impr.) ; 67(4): 341-344, mayo 2014. ilus
Artigo em Espanhol | IBECS | ID: ibc-122092

RESUMO

OBJETIVO: La amiloidosis es una enfermedad caracterizada por el depósito de material hialino eosinofílico en distintos tejidos, siendo muy infrecuente la afectación vesical. Nuestro objetivo es dar a conocer un nuevo caso de amiloidosis vesical primaria de tipo AA y una revisión de la literatura al respecto. MÉTODO: Varón de 66 años de edad que acude a consulta por referir hematuria intermitente de dos semanas de evolución, junto con urgencia y nicturia de 10-12 veces. La exploración física abdominal y genital resultó anodina así como el sedimento, urocultivo y citologías (microhematuria e inflamación). En cistoscopia se apreció, a nivel de trígono y fondo vesical, una mucosa con lesiones eritematosas-amarillentas, ligeramente sobreelevadas que se biopsian. El resultado anatomopatológico fue de mucosa urotelial con marcada inflamación crónica y acúmulos perivasculares de material hialino de aspecto amiloide. Se completó el tratamiento con resección transuretral de la lesión vesical confirmando el diagnóstico de amiloidosis vesical tipo AA (propio de formas secundarias). El estudio de probable afectación sistémica fue normal. RESULTADOS: Tras dos años de seguimiento el paciente se encuentra asintomático, sin evidencia de recidiva en las cistoscopias. CONCLUSIONES: Las formas de amiloidosis vesical primaria de tipo AA son una patología muy infrecuente, con pocos casos descritos en la literatura urológica internacional. No obstante debemos tenerla en cuenta en el diagnóstico diferencial ante un paciente con hematuria y/o sintomatología urinaria persistente (AU)


OBJECTIVE: Amyloidosis is a disease characterised by deposition of eosinophilic hyaline material in different tissues. Urinary bladder involvement is uncommon with less than 200 cases of the primary form published in the literature. We present a new case of primary AA type amyloidosis of the urinary bladder (typical of secondary forms). METHODS: A 66-year-old male was seen in the outpatient urology consultation with several-weeks history intermittent haematuria with decreased voiding urinary calibre. In addition, he had intense nocturia, 10-12 times per night, and occasional urgency. Physical examination of the abdomen and genitals was unremarkable. Urine sediment and blood tests were normal. Urine cytology studies were requested and revealed urothelial cells with no atypical cells and a moderate quantity of neutrophils and erythrocytes. Cystoscopy was performed and revealed yellowish erythematous lesions at the level of the vesicoureteric junction and the fundus. The lesions were biopsied. Pathology studies revealed urothelial mucosa with marked chronic inflammation and accumulations of amyloid-appearing hyaline material in the area of the vessels with green birefringence on polarised light. TUR of the bladder was later performed with the goal of completely resecting the lesion. The result of the pathology studies confirmed the biopsy findings and immunohistochemistry studies revealed AA type amyloid (typical of secondary forms). RESULTS: Two years after the intervention, the patient remains asymptomatic with normal endoscopic follow-up studies. CONCLUSIONS: Primary AA type amyloidosis of the bladder is a very uncommon pathology with few cases reported in the international urology literature. Nevertheless, we must keep it in mind in the differential diagnosis when faced with a patient with haematuria and/or persistent urinary symptoms (AU)


Assuntos
Humanos , Masculino , Idoso , Amiloidose/diagnóstico , Doenças da Bexiga Urinária/diagnóstico , Hematúria/etiologia , Cistoscopia , Biópsia
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