Kobayashi Takaaki, Roberts John, Levine Jeffrey, Degrado Justin
Department of Internal Medicine, United States Naval Hospital Yokosuka, Japan.
Intern Med. 2014;53(21):2511-3. doi: 10.2169/internalmedicine.53.2903. Epub 2014 Nov 1.
Primary bladder amyloidosis is a rare disease, with only 200 cases reported worldwide. This condition is clinically important since it masquerades as a malignancy. We herein present a case of primary bladder amyloidosis presenting as painless hematuria and dysuria. Computed tomography and ultrasound showed thickening of the posterior bladder wall. Cystoscopy revealed abnormal bladder tissue suspicious of malignancy. However, transurethral resection of a bladder tumor showed no evidence of malignant cells. Amyloid was identified on Congo red staining. Therefore, the possibility of secondary amyloidosis was ruled out and a diagnosis of primary bladder amyloidosis was made. Nine months after undergoing primary resection, the patient's amyloidosis recurred at the initial site.
原发性膀胱淀粉样变性是一种罕见疾病，全球仅报道过200例。这种疾病具有临床重要性，因为它易被误诊为恶性肿瘤。我们在此报告一例以无痛性血尿和排尿困难为表现的原发性膀胱淀粉样变性病例。计算机断层扫描和超声检查显示膀胱后壁增厚。膀胱镜检查发现异常膀胱组织，怀疑为恶性肿瘤。然而，经尿道膀胱肿瘤切除术未发现恶性细胞证据。刚果红染色鉴定出淀粉样物质。因此，排除了继发性淀粉样变性的可能性，确诊为原发性膀胱淀粉样变性。初次切除术后九个月，患者的淀粉样变性在原部位复发。
