Urine cytology of localized primary amyloidosis of the ureter: a case report.
BACKGROUND
Morphologic findings of amyloid in urine cytology material have rarely been reported because amyloidosis of the urinary tract is a relatively uncommon disorder. We present a case of primary amyloidosis of the ureter, including catheterized urine cytologicfindings.


METHODS
A 78-year-old man had pollakiuria and dysuria for 5 years before admission after transurethral resection of the prostate. Clinical examination revealed left hydronephrosis and stricture of the lower part of the left ureter, and a malignant ureteral tumor was suspected clinically. In catheterized urine cytology, many clusters of epithelial cells, inflammatory cells and abundant, amorphous, waxy material were observed. The amorphous material stained light green by the Papanicolaou method and positive with direct fast scarlet (DFS), showing yellow-green birefringence under polarized light. Positivity with DFS staining was not affected by treatment with potassium permanganate. Immunocytochemically the material was AL-type amyloid protein. Atypia were absent from epithelial cells. The patient had no history of diseases that could cause secondary amyloidosis. The present case was considered to be primary amyloidosis localized to the left ureter because no particular morphologic change in the epithelial cells of the urinary tract was observed.


CONCLUSIONS
Amyloid can be present in urine and should not be overlooked or confused with tumor diathesis when a malignant tumor is suspected clinically.
Takahashi
Tasuya
T
Department of Laboratory Medicine and Pathology Laboratory, University Hospital, Shimane University School of Medicine/Nursing, Izumo, Shimane, Japan.
Miura
Hiroshi
H
Matsu-ura
Yukihiro
Y
Iwana
Shinji
S
Maruyama
Riruke
R
Harada
Takayuki
T
D000368:Aged; D000682:Amyloid / Q000652:urine*; D000686:Amyloidosis / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008297:Male; D020728:Transurethral Resection of Prostate; D014515:Ureteral Diseases / Q000473:pathology*
D000682:Amyloid