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经前列腺活检偶然诊断出的系统性转甲状腺素蛋白淀粉样变性:一例报告

Systemic Transthyretin Amyloidosis Incidentally Diagnosed With Prostate Biopsy: A Case Report.

作者信息

Nakamura Michihide, Kuroda Shinnosuke, Kawahara Takashi, Muraoka Erika, Iwamoto Genya, Shimokihara Kota, Noguchi Takeaki, Yamazaki Masanobu, Hashizume Akihito, Takamoto Daiji, Horii Rie, Fujii Satoshi, Tanoshima Miki, Teranishi Junichi, Uemura Hiroji

机构信息

Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan.

Department of Clinical Genetics Yokohama City University Medical Center Yokohama Japan.

出版信息

IJU Case Rep. 2025 Aug 1;8(5):503-507. doi: 10.1002/iju5.70079. eCollection 2025 Sep.

Abstract

INTRODUCTION

The diagnosis of systemic transthyretin amyloidosis based on prostate biopsy is very rare, and we report this case with a literature review.

CASE PRESENTATION

A 73-year-old male patient was referred to our department due to an increased serum prostate-specific antigen level at 10.4 ng/mL while receiving benign prostatic hypertrophy treatment. Prostate needle biopsy was performed, and the pathology revealed transthyretin amyloid deposits in the prostate tissue without adenocarcinoma. Subsequent 99mTc pyrophosphate scintigraphy confirmed the accumulation in the myocardium. The patient was diagnosed with cardiac transthyretin amyloidosis.

CONCLUSION

Amyloidosis is a systemic disease where amyloid is deposited in multiple organs, causing various dysfunctions. Considering both our case and previous reports, prostatic amyloidosis may frequently be associated with systemic involvement. The treatments including oligonucleotide therapeutic agents and transthyretin-stabilizing drugs will be more effective with early diagnosis and early treatment, and various symptoms suspicious of systemic amyloidosis should not be missed.

摘要

引言

基于前列腺活检诊断系统性转甲状腺素蛋白淀粉样变性极为罕见,我们报告此病例并进行文献复习。

病例介绍

一名73岁男性患者,在接受良性前列腺增生治疗时,血清前列腺特异性抗原水平升高至10.4 ng/mL,遂转诊至我科。进行了前列腺穿刺活检,病理显示前列腺组织中有转甲状腺素蛋白淀粉样沉积物,无腺癌。随后的99mTc焦磷酸盐闪烁扫描证实心肌有积聚。该患者被诊断为心脏转甲状腺素蛋白淀粉样变性。

结论

淀粉样变性是一种全身性疾病,淀粉样物质沉积于多个器官,导致各种功能障碍。结合我们的病例和既往报道,前列腺淀粉样变性可能常伴有全身受累。包括寡核苷酸治疗药物和转甲状腺素蛋白稳定药物在内的治疗,早期诊断和早期治疗会更有效,不应漏诊各种可疑的系统性淀粉样变性症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f761/12408183/c0b239ba2382/IJU5-8-503-g003.jpg

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