Iida Shoichi, Chujyo Takashi, Nakata Yasunobu, Iuchi Hiromichi
Department of Urology, Nakata Urological Hospital.
Hinyokika Kiyo. 2003 Jul;49(7):423-6.
We report a case of localized amyloidosis of the renal pelvis and upper ureter arising in a 74-year-old man who presented at our hospital with gross hematuria. The intravenous pyelogram showed right hydronephrosis and stenosis of right renal pelvis and upper ureter. The cystoscopy view was normal, but the right retrograde-ureteropyelogram showed a long irregular stricture of the renal pelvis. Ureteroscopy was performed and rubbing biopsy of edematous, bleeding lesion suggested class IIIb, transitional cell carcinoma. With the diagnosis of a right renal pelvic tumor, right nephroureterectomy was performed. The histology report stated "massive deposits of amyloids are seen in the segment of macroscopically abnormal renal pelvis". Amyloidosis of the renal pelvis is a rare entity and 12 cases were reported in the Japanese and English literature.
我们报告一例74岁男性肾盂及上段输尿管局限性淀粉样变性病例,该患者因肉眼血尿就诊于我院。静脉肾盂造影显示右肾积水以及右肾盂和上段输尿管狭窄。膀胱镜检查视野正常,但右逆行输尿管肾盂造影显示肾盂有一段长的不规则狭窄。进行了输尿管镜检查,对水肿、出血病变进行擦取活检提示为Ⅲb级移行细胞癌。鉴于诊断为右肾盂肿瘤,遂行右肾输尿管切除术。组织学报告称“在肉眼可见异常的肾盂段可见大量淀粉样蛋白沉积”。肾盂淀粉样变性是一种罕见疾病,日本和英文文献中共报道了12例。