title: Characterization of localized seminal vesicle amyloidosis causing hemospermia: an analysis using immunohistochemistry and magnetic resonance imaging.
abstract: OBJECTIVE
  We evaluated the characteristics of seminal vesicle amyloidosis (SVA) associated with hemospermia by immunohistochemistry and magnetic resonance imaging (MRI) as well as the clinical course of hemospermia.
  
  
  METHODS
  Of 56 patients with hemospermia 12 underwent transperineal biopsy of the seminal vesicle under transrectal ultrasound monitoring. SVA was proved in 4 men 48 to 59 years old by histological and immunohistochemical examinations of specimens obtained by biopsy. Two men presented with the first episode of hemospermia and 2 presented with recurrent hemospermia. MRI at 1.5 Tesla was performed while hemospermia persisted and after its resolution. Patients were followed for 10 to 86 months with regard to the duration of hemospermia, the time of its resolution and its recurrence.
  
  
  RESULTS
  Amyloid deposits in the subepithelial tissue of the seminal vesicles were permanganate sensitive, and positive for lactoferrin and the amyloid P component but negative for amyloid A protein, lambda and kappa chains, and beta2-microglobulin. The seminal vesicles with obvious intravesicular hemorrhage on needle puncture were hyperintense on T1-weighted images. After hemospermia resolution T1-weighted images became diffusely hypointense. T2-weighted images were of low intensity, representing amyloid deposits. Hemospermia resolved spontaneously in all patients in an average of 14 months. Although disease recurred in 1 patient after 8 months of resolution, it disappeared after 11 months of recurrence.
  
  
  CONCLUSIONS
  Localized SVA with hemospermia shows hypointensity on T2-weighted MRI. Hemospermia is spontaneously resolved with the transition from hyperintense to hypointense T1-weighted MRI.
authors.affiliation: Department of Urology, Furuya Hospital, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Furuya
authors.forename: Naoya
authors.initials: N
authors.lastname: Masumori
authors.forename: Ryoji
authors.initials: R
authors.lastname: Furuya
authors.forename: Taiji
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Isomura
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Tamakawa
mesh_terms: D000682:Amyloid / Q000032:analysis; D000686:Amyloidosis / Q000150:complications* / Q000473:pathology; D001707:Biopsy, Needle; D001769:Blood; D004848:Epithelium / Q000473:pathology; D005500:Follow-Up Studies; D005832:Genital Diseases, Male / Q000150:complications* / Q000473:pathology; D006470:Hemorrhage / Q000473:pathology; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000032:analysis; D007146:Immunoglobulin lambda-Chains / Q000032:analysis; D007150:Immunohistochemistry; D007781:Lactoferrin / Q000032:analysis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012075:Remission, Spontaneous; D012661:Semen; D012669:Seminal Vesicles / Q000473:pathology*; D000685:Serum Amyloid A Protein / Q000032:analysis; D000683:Serum Amyloid P-Component / Q000032:analysis; D018084:Ultrasonography, Interventional; D001613:beta 2-Microglobulin / Q000032:analysis
chemical_list: D000682:Amyloid; D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains; D000685:Serum Amyloid A Protein; D000683:Serum Amyloid P-Component; D001613:beta 2-Microglobulin; D007781:Lactoferrin