Primary Localized Amyloidosis of Urinary Bladder: A Case Report and Review of Literature

Abstract

Amyloidosis is a disorder of protein metabolism characterized by extracellular deposition of abnormal protein fibrils. It may either be localized to any organ or systematically distributed throughout the body. The biochemical nature of proteins varies but the physical and tinctorial properties are shared by all the amyloidogenic proteins. In the West, it is mainly composed of amyloid light (AL) type immunoglobulin (Ig) light chains. Amyloidosis of the genitourinary tract is rare except for the kidney and isolated primary amyloidosis of the urinary bladder is even rarer. It mainly presents as intermittent painless gross hematuria. It mimics transitional cell carcinoma on imaging and endoscopic examination. We herein present a case of fifty six-years-old male with history of painless hematuria for three months. Cystoscopy revealed a 1 cm hyperemic area on the posterior wall of urinary bladder. The biopsy showed features of amyloidosis and amyloid A (AA) immunostaining was negative. Extensive workup was done to exclude other sites of involvement and a final diagnosis of primary localized amyloidosis of the urinary bladder was made. The patient is on regular follow-up.

Secondary bladder amyloidosis with familial Mediterranean fever in a living donor kidney transplant recipient: a case report

“…Hematuria has a prevalence of 12 % in the post renal transplant patients with the major causes such as urinary tract infection, genitourinary malignancies, graft rejection, recurrences of primary disease and calculus [ 5 ]. Although bladder amyloidosis mainly presented intermittent painless macroscopic hematuria [ 6 ], we had not considered bladder amyloidosis at the time of the presence of macroscopic hematuria because of its rare cause of macroscopic hematuria in post renal transplant patients.…”

New case of secondary bladder amyloidosis with massive hematuria—role of intravesical instillations with dimethyl sulfoxide

“…The most preferred site of amyloid deposit is the posterior bladder wall (68%), followed by the trigone (26%) (8). Macroscopic hematuria, with or without clots, is the predominant and frequently the unique clinical manifestation, although it can also manifest as irritative voiding symptoms such as dysuria or pollakiuria (9). Without adequate treatment, the evolution of these patients can be complicated (10) and even fatal (11).…”

Primary Vesical Amyloidosis Masquerading as Vesical Calculus in a Retroviral Positive Patient

“…These lesions commonly confused with malignancy. Painless gross haematuria is the main presenting symptoms in most of the patients [2-4]. Accurate diagnosis depends on the biopsy of the lesion and immunohistochemical (IHC) studies identifying the amyloid type [2,3].…”