Answer: Submucosal amyloid deposition

Histology: none provided

Discussion: Amyloidosis of the bladder can be localized to the bladder or one manifestation of disseminated amyloidosis. It can also be primary associated with some type of immune dyscrasia (deposition of AL) or secondary when it occurs as a consequence of an underlying chronic inflammatory or tissue destructive process (deposition of AA). Primary amyloidosis of the bladder usually occurs in older patients. Patients present with gross hematuria in the majority of cases and rarely with irritative lower tract symptoms. The clinical, radiological and cystoscopic findings closely simulate bladder malignancy. Local recurrences are common. The diagnosis is done on bladder biopsy with Congo red staining. Immunostain can also be performed to detect the type of amyloid.