title: [Cholesterol embolism of the upper urinary tract as a clinical feature of atherosclerotic embolic vascular disease. Report of three cases, one of them simulating neoplasia].
abstract: OBJECTIVE
  To report three cases of atherosclerotic embolic vascular disease with clinical presentation in the lower urinary tract. This disease is not frequent; it mainly affects the skin, kidneys and skeletal muscle. Other organs of the urinary tract are rarely affected and they are exceptionally the clinical site of debut without previous known involvement of other areas.
  
  
  RESULTS
  The first patient presented with hematuria associated with an ultrasound/cystoscopical image suspicion for neoplasia. Pathologic report of the transurethral resection chips showed polypoid cystitis with some small size arteries occupied by cholesterol needles, associated with inflammation, ulcers and hematic extravasation. The second patient underwent cystoprostatectomy for a transitional cell carcinoma and, incidentally, numerous cholesterol emboli were found, mainly in the lamina propria, but also in other layers of the bladder wall, prostate, urethra, veru montanum, and one seminal vesicle; this two latter sites have not being reported in previous publications. The third patient showed the embolus within a prostate biopsy core.
  
  
  CONCLUSIONS
  This unfrequent disease may present as a bladder or prostatic process and be diagnosed by biopsy of these organs. It may simulate a bladder neoplasia on ultrasound or cystoscopy and should be included among related or etiologic entities of polypoid cystitis, a well-known simulator of neoplasia.
authors.affiliation: Servicio de Anatomía Patológica, Hospital de León, León, España. fizquierdo@hleo.sacyl.es
authors.forename: Francisco Miguel
authors.initials: FM
authors.lastname: Izquierdo-García
authors.forename: Elena
authors.initials: E
authors.lastname: Reimunde-Seoane
authors.forename: Ana
authors.initials: A
authors.lastname: González Medina
authors.forename: Fructuoso
authors.initials: F
authors.lastname: García Díez
authors.forename: Dimas
authors.initials: D
authors.lastname: Suarez-Vilela
authors.forename: Teresa
authors.initials: T
authors.lastname: Ribas-Ariño
authors.forename: Manuel
authors.initials: M
authors.lastname: Roa-Luzuriaga
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000150:complications*; D003937:Diagnosis, Differential; D017700:Embolism, Cholesterol / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008297:Male; D001745:Urinary Bladder Diseases / Q000175:diagnosis* / Q000209:etiology*; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis*