V08_No_2_Final.pdf


Pictorial Urology

97Urology Journal   Vol 8   No 2   Spring 2011

Bladder Amyloidosis Mimicking Carcinoma

Urol J. 2011;8:97.
www.uj.unrc.ir

An 80-year-old ex-smoker man presented with one episode of gross painless hematuria. His past medical 
history included hypertension, cerebrovascular accident, and osteoarthritis. Physical examination, 
routine blood tests, and ultrasonography were normal. Urine culture, microscopy, and cytology were 
unremarkable. On cystoscopy, a suspicious looking papillary mass was noted on the bladder roof, 
which was resected transurethrally. Histopathology revealed amyloidosis of the bladder, confirmed with 
alkaline Congo red staining showing apple-green birefringence in polarized light.

Amyloidosis is characterized by deposition of extracellular, hyaline, amorphous, and proteinaceous 
material in various organs of the body. It can be classified into (a) primary type, which is associated 
with an immunocyte dyscrasia; and (b) secondary type, which occurs as a complication of an underlying 
chronic inflammatory process.(1) Although rare, it remains a differential diagnosis in patients with painless 
hematuria.(2) In elderly, suspicion should be raised in those who have systemic underlying conditions.

Ashok Kumar Singh,* Michael St J Floyd (Jr), Alan Robert De Bolla
Department of Urology, Wrexham Maelor Hospital, Wrexham, Wales, LL13 7TZ

*E-mail: ashoksingh03@yahoo.co.uk

REFERENCES
1. Mitchell R, Kumar V. Amyloidosis. In: Kumar V, Cotran RS, Robbins SL, eds. Robbins Basic Pathology. 7th ed. Philadelphia: 

Elsevier Saunders; 2003:158-64.

2. Caldamone AA, Elbadawi A, Moshtagi A, Frank IN. Primary localized amyloidosis of urinary bladder. Urology. 1980;15:174-80.