Primary localized amylodoisis of bladder: Is there a need for cystoscopic surveillance?

Abstract

Amyloidosis is a heterogeneous group of disorders characterized by extracellular deposition of amorphous proteinaceous material in various tissues. Amyloidosis of bladder is of significant clinical interest to the urologist because of its presentation as urothelial cancer. Transurethral resection and histology examination is essential to exclude malignancy and to establish the benign nature of amyloidosis. Apart from managing the localized bladder amyloidosis, it is important to exclude systemic amyloidosis. Here in we describe two cases of localized, primary amyloidosis and discuss briefly their management and follow-up.

Primary amyloidosis of the bladder

“…Amyloidosis is a rare disease of disordered protein metabolism characterised by extracellular protein deposition of monoclonal light chains, which can either be lambda or kappa light chains. 1 It is usually a systemic disorder, but it may rarely present in a localised organ. 2 Urinary tract amyloidosis is rare and bladder primary bladder amyloidosis has approximately 200 cases reported worldwide.…”

“… 4 Bladder amyloid classically presents with visible haematuria and storage bladder symptoms, mimicking bladder malignancy. 1 , 2 , 3 , 4 …”

Amiloidosis vesical: una causa poco frecuente de hematuria macroscópica

“…La amiloidosis primaria vesical es una entidad clínica poco común siendo de particular interés para el urólogo dado que a menudo es confundida de forma inicial con un tumor vesical. Fue descrita por primera vez en 1987 durante una autopsia y desde entonces se han descrito algo más de 200 casos en la literatura mundial 5 .…”

“…La resección transuretral de la lesión y el examen histopatológico son necesarios para excluir malignidad y establecer el diagnóstico de amiloidosis; excluir presencia de amiloidosis secundaria así como posibles causas es también imperativo. El curso clínico de esta entidad es usualmente benigno y la escisión quirúrgica puede ser el único tratamiento requerido 5,9 .…”

Primary bladder amyloidosis as a cause of haematuria

“…The aetiology is poorly understood, although it has been hypothesised that chronic inflammation in the bladder recruits lymphoplasmacytic cells to the bladder submucosa 2. It usually presents with painless haematuria and is an important diagnosis to be aware of as it can mimic bladder neoplasia clinically, cystoscopically and radiologically 3.…”