Ehara H, Kobayashi K, Deguchi T, Kitajima W
Kidney Disease Center, Shakaihoken Saitama Chuo Hospital.
Hinyokika Kiyo. 1989 Sep;35(9):1601-5.
We report a case of primary localized amyloidosis of the bladder which manifested post-renal failure. A 79-year-old woman with diabetes mellitus complained of anorexia and oliguria. Computed tomographic (CT) scan showed bilateral hydronephrosis. Cystoscopic examination revealed a broad-based nonpapillary tumor in the trigonum of the bladder and CT scan demonstrated thickening of the posterior wall of the bladder. Pathological examination of the transurethral biopsy specimen revealed amyloid deposits in the submucosa, but no malignant changes were found. Cytodiagnosis of washing fluid of the bladder revealed amyloid deposits around the exfoliative cells. Serum electrophoresis showed a normal pattern. Urinary Bence-Jones protein was not detected. Amyloid deposits were not found in rectal mucosa. Systemic or secondary amyloidosis was ruled out from these findings, and primary localized amyloidosis of the bladder was diagnosed. The mass of the bladder was transurethrally resected and pig-tail stents were indwelt. These procedures gave a satisfactory result.
我们报告一例表现为肾衰竭后的膀胱原发性局限性淀粉样变性病例。一名79岁的糖尿病女性患者主诉厌食和少尿。计算机断层扫描（CT）显示双侧肾积水。膀胱镜检查发现膀胱三角区有一个广基无蒂肿瘤，CT扫描显示膀胱后壁增厚。经尿道活检标本的病理检查显示黏膜下有淀粉样沉积，但未发现恶性改变。膀胱冲洗液的细胞诊断显示脱落细胞周围有淀粉样沉积。血清电泳显示正常模式。未检测到尿本-周蛋白。直肠黏膜未发现淀粉样沉积。根据这些发现排除了全身性或继发性淀粉样变性，诊断为膀胱原发性局限性淀粉样变性。经尿道切除膀胱肿物并留置猪尾支架。这些操作取得了满意的效果。
