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Presented by Jonathan Epstein, M.D. and prepared by Greg Seidel, M.D.
Case 2: 38-year-old female with gross hematuria.
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Question 1 of 1
1. Question
Week 104: Case 2
38-year-old female with gross hematuria./images/0930022c.jpg
/images/0930022a.jpg
/images/0930022b.jpgCorrect
Answer: Amyloidosis
Histology: Acellular amorphous eosinophilic amyloid deposits are noted within the lamina propria. Deposits are also localized around a vessel.
Discussion: The findings in this case are classic for amyloidosis and there is no other reasonable differential. To verify the diagnosis, stains for amyloid could be performed. Most cases of amyloidosis in the bladder represent primary amyloidosis. Secondary involvement of the bladder in cases of systemic amyloidosis is rare. Primary amyloidosis typically involves the lamina propria. In some cases the deposits are not localized around vessels, but in others, such as in the current cases, it may be perivascular in distribution. Clinically, patients present with marked hematuria as a result of the abnormal deposits around the vessels. In some cases the histological findings may be subtle.
Incorrect
Answer: Amyloidosis
Histology: Acellular amorphous eosinophilic amyloid deposits are noted within the lamina propria. Deposits are also localized around a vessel.
Discussion: The findings in this case are classic for amyloidosis and there is no other reasonable differential. To verify the diagnosis, stains for amyloid could be performed. Most cases of amyloidosis in the bladder represent primary amyloidosis. Secondary involvement of the bladder in cases of systemic amyloidosis is rare. Primary amyloidosis typically involves the lamina propria. In some cases the deposits are not localized around vessels, but in others, such as in the current cases, it may be perivascular in distribution. Clinically, patients present with marked hematuria as a result of the abnormal deposits around the vessels. In some cases the histological findings may be subtle.
