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Presented by Pedram Argani, M.D. and prepared by Wang (Steve) Cheung, M.D., Ph.D.
Case 1: 58 year old male with a ureter mass and hematuria.
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Question 1 of 1
1. Question
Week 325: Case 1
58 year old male with a ureter mass and hematuria./images/926071a.jpg
/images/926071b.jpg
/images/926071c.jpgCorrect
Answer: Amyloidosis
Histology: The lamina propria of the ureter contains eosinophilic, hyalinized deposits which surround smooth muscle bundles. Inflammatory cells are scant, and the overlying urothelium is normal. Special stains for Congo Red reveal apple-green birefringence under polarized light.
Discussion: Non-specific fibrosis would be more cellular and lack the hyalinized appearance of amyloidosis. Foreign material would be associated with a giant cell reaction. Urothelial carcinoma would feature malignant urothelial cells instead of the hyalinized material in the present case.
Cases of amyloidosis may be localized or systemic. In cases of systemic amyloidosis, the amyloid is typically extensively perivascular. In localized amyloidosis, excision of localized lesions and close follow-up is appropriate.
Incorrect
Answer: Amyloidosis
Histology: The lamina propria of the ureter contains eosinophilic, hyalinized deposits which surround smooth muscle bundles. Inflammatory cells are scant, and the overlying urothelium is normal. Special stains for Congo Red reveal apple-green birefringence under polarized light.
Discussion: Non-specific fibrosis would be more cellular and lack the hyalinized appearance of amyloidosis. Foreign material would be associated with a giant cell reaction. Urothelial carcinoma would feature malignant urothelial cells instead of the hyalinized material in the present case.
Cases of amyloidosis may be localized or systemic. In cases of systemic amyloidosis, the amyloid is typically extensively perivascular. In localized amyloidosis, excision of localized lesions and close follow-up is appropriate.
