Tan S M, Tan P K, Yap W M
Department of Surgery, Tan Tock Seng Hospital, Singapore.
Ann Acad Med Singap. 1996 Jul;25(4):612-3.
An otherwise healthy elderly lady who presented with gross haematuria was found to have a papillary lesion in her bladder. Histological examination of the lesion showed amyloid deposits. Investigations for systemic amyloidosis were all negative. Primary amyloidosis of the bladder is a rare clinicopathological condition with only 57 documented cases in the medical literature. It often mimics bladder carcinoma in presentation and cystoscopic appearance. Amyloid deposits in the bladder may be primary (organ-limited amyloidosis) or part of systemic amyloidosis. Exclusion of systemic amyloidosis is important for management and prognosis. Localised primary lesions are best treated with transurethral resection and recurrences are uncommon. Diffuse involvement of the bladder is difficult to manage and may require urinary diversion. We report the first case of primary amyloidosis of the bladder in Singapore.
一位原本健康的老年女性因肉眼血尿就诊,发现膀胱有乳头状病变。病变的组织学检查显示有淀粉样沉积物。系统性淀粉样变性的各项检查均为阴性。膀胱原发性淀粉样变性是一种罕见的临床病理状况,医学文献中仅有57例记录病例。其临床表现和膀胱镜检查表现常与膀胱癌相似。膀胱中的淀粉样沉积物可能是原发性的(器官局限性淀粉样变性)或系统性淀粉样变性的一部分。排除系统性淀粉样变性对治疗和预后很重要。局限性原发性病变最好采用经尿道切除术治疗,复发并不常见。膀胱弥漫性受累难以处理,可能需要尿流改道。我们报告了新加坡首例膀胱原发性淀粉样变性病例。