Difference between revisions of "Urinary bladder amyloidosis"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Urinary bladder amyloidosis -- low mag.jpg
| Width      =
| Caption    = Urinary bladder amyloidosis. [[H&E stain]].
| Synonyms  = amyloidosis of the urinary bladder
| Micro      = lamina propria with amyloid (amorphous, paucicellular, pink material on H&E - classically "cracked")
| Subtypes  =
| LMDDx      = fibrosis, fibrin, [[leiomyoma]]
| Stains    = [[Congo red]] +ve
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[urinary bladder]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = very rare
| Bloodwork  =
| Rads      = thickened bladder wall
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    = other urinary bladder tumours - esp. malignant ones
| Tx        =
}}
'''Urinary bladder amyloidosis''', more formally '''primary urinary bladder amyloidosis''', is a rare benign condition of [[urinary bladder]] that can mimic [[cancer]] of the [[urinary bladder]].<ref name=pmid25366012>{{Cite journal  | last1 = Kobayashi | first1 = T. | last2 = Roberts | first2 = J. | last3 = Levine | first3 = J. | last4 = Degrado | first4 = J. | title = Primary bladder amyloidosis. | journal = Intern Med | volume = 53 | issue = 21 | pages = 2511-3 | month =  | year = 2014 | doi =  | PMID = 25366012 }}</ref>
'''Urinary bladder amyloidosis''', more formally '''primary urinary bladder amyloidosis''', is a rare benign condition of [[urinary bladder]] that can mimic [[cancer]] of the [[urinary bladder]].<ref name=pmid25366012>{{Cite journal  | last1 = Kobayashi | first1 = T. | last2 = Roberts | first2 = J. | last3 = Levine | first3 = J. | last4 = Degrado | first4 = J. | title = Primary bladder amyloidosis. | journal = Intern Med | volume = 53 | issue = 21 | pages = 2511-3 | month =  | year = 2014 | doi =  | PMID = 25366012 }}</ref>


==General==
==General==
*Rare - approximately 200 reported cases as of 2014.<ref name=pmid25366012/><ref name=pmid24857645>{{Cite journal  | last1 = Schou-Jensen | first1 = KS. | last2 = Dahl | first2 = C. | last3 = Pilt | first3 = AP. | last4 = Azawi | first4 = NH. | title = Amyloidosis in the bladder: three cases with different appearance. | journal = Scand J Urol | volume = 48 | issue = 5 | pages = 489-92 | month = Oct | year = 2014 | doi = 10.3109/21681805.2014.920414 | PMID = 24857645 }}</ref>
*Primary bladder amyloidosis is rare - approximately 200 reported cases as of 2014.<ref name=pmid25366012/><ref name=pmid24857645/>
*May clinically mimic bladder cancer.<ref name=pmid25366012/>
**Systemic [[amyloidosis]] should be excluded.<ref name=pmid24857645>{{Cite journal  | last1 = Schou-Jensen | first1 = KS. | last2 = Dahl | first2 = C. | last3 = Pilt | first3 = AP. | last4 = Azawi | first4 = NH. | title = Amyloidosis in the bladder: three cases with different appearance. | journal = Scand J Urol | volume = 48 | issue = 5 | pages = 489-92 | month = Oct | year = 2014 | doi = 10.3109/21681805.2014.920414 | PMID = 24857645 }}</ref>
*May clinically mimic [[bladder cancer]].<ref name=pmid25366012/>


==Gross==
==Gross==
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==Microscopic==
==Microscopic==
Features:
Features:
*Lamina propria with amyloid (amorphous, paucicellular, pink material on H&E - classically "cracked").
*Lamina propria with amyloid.
**Amyloid = amorphous, paucicellular material that is [[pink on H&E]], classically has "cracked" appearance.
***"Cracked": irregular fragments where the edges and centre of fragments are homogeneous.
 
DDx:
*Fibrin.
*Fibrosis.
*[[Leiomyoma]].
 
===Images===
<gallery>
Image: Urinary bladder amyloidosis -- very low mag.jpg | UBA - very low mag. (WC)
Image: Urinary bladder amyloidosis -- low mag.jpg | UBA - low mag. (WC)
Image: Urinary bladder amyloidosis -- intermed mag.jpg | UBA - intermed. mag. (WC)
Image: Urinary bladder amyloidosis -- high mag.jpg | UBA - high mag. (WC)
</gallery>


==Stains==
==Stains==
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- Benign muscularis propria present.
- Benign muscularis propria present.
- NEGATIVE for urothelial carcinoma in situ.
- NEGATIVE for urothelial carcinoma in situ.
- NEGATIVE for malignancy.
- NEGATIVE for evidence of malignancy.


Comment:  
Comment:  
Congo red staining and polarization confirm the presence of amyloid.
Congo red staining and polarization confirm the presence of amyloid.


Systemic causes of amyloidosis should be considered clinically.
Primary bladder amyloidosis is rare; systemic causes of amyloidosis should  
be considered.
</pre>
</pre>


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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Genitourinary pathology]]
[[Category:Genitourinary pathology]]

Latest revision as of 03:44, 23 October 2015

Urinary bladder amyloidosis
Diagnosis in short

Urinary bladder amyloidosis. H&E stain.

Synonyms amyloidosis of the urinary bladder

LM lamina propria with amyloid (amorphous, paucicellular, pink material on H&E - classically "cracked")
LM DDx fibrosis, fibrin, leiomyoma
Stains Congo red +ve
Site urinary bladder

Prevalence very rare
Radiology thickened bladder wall
Clin. DDx other urinary bladder tumours - esp. malignant ones

Urinary bladder amyloidosis, more formally primary urinary bladder amyloidosis, is a rare benign condition of urinary bladder that can mimic cancer of the urinary bladder.[1]

General

Gross

  • Urinary bladder wall thickening.[1]

Microscopic

Features:

  • Lamina propria with amyloid.
    • Amyloid = amorphous, paucicellular material that is pink on H&E, classically has "cracked" appearance.
      • "Cracked": irregular fragments where the edges and centre of fragments are homogeneous.

DDx:

Images

Stains

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Urinary Bladder, Transurethral Resection:
- Urothelial mucosa with amyloidosis and mild chronic inflammation.
- Benign muscularis propria present.
- NEGATIVE for urothelial carcinoma in situ.
- NEGATIVE for evidence of malignancy.

Comment: 
Congo red staining and polarization confirm the presence of amyloid.

Primary bladder amyloidosis is rare; systemic causes of amyloidosis should 
be considered.

See also

References

  1. 1.0 1.1 1.2 1.3 Kobayashi, T.; Roberts, J.; Levine, J.; Degrado, J. (2014). "Primary bladder amyloidosis.". Intern Med 53 (21): 2511-3. PMID 25366012.
  2. 2.0 2.1 Schou-Jensen, KS.; Dahl, C.; Pilt, AP.; Azawi, NH. (Oct 2014). "Amyloidosis in the bladder: three cases with different appearance.". Scand J Urol 48 (5): 489-92. doi:10.3109/21681805.2014.920414. PMID 24857645.