Bilateral localized amyloidosis of the ureters: clinicopathology and therapeutic approaches in two cases.
Localized amyloidosis in the ureter is a rare condition, in which immunoglobulin light chain is locally synthesized, causing thickening of ureteric walls by deposits of immunoglobulin-related amyloid. Since the clinical features of ureteral amyloidosis with ureteric stricture and/or hydroureteronephrosis closely resemble those of malignancy involving the ureters, nephroureterctomy is usually performed for this disease. We describe two aged patients with localized amyloidosis on the bilateral ureters. In both cases, left hydronephrosis with left ureteral stricture was found. They were treated with total nephroureterctomy and Alambda amyloid deposition was confirmed in the resected ureters. Several months later right ureteral stenosis was found. One patient was treated with percutaneous nephrostomy to preserve his renal function and the other with corticosteroids. This appeared to result in significant regression of the stenotic lesion. In both cases, all examinations for systemic involvement of organs were negative. Corticosteroids may be of use in treating immunoglobulin-derived localized amyloidosis in the ureters.
Fushimi
Tomohisa
T
Third Department of Medicine, Shinshu University School of Medicine, Matsumoto 390-8621, Japan. kirisame@hsp.md.shinshu-u.ac.jp
Takei
Yo-ichi
Y
Touma
Tuguhiro
T
Kudoh
Shigemasa
S
Yamamoto
Kanji
K
Hoshii
Yoshinobu
Y
Ishihara
Tokuhiro
T
Ikeda
Shu-ichi
S
D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D014513:Ureter / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D014517:Ureteral Obstruction / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D014519:Ureterostomy