Subepithelial pelvic hematoma (Antopol--Goldman lesion) simulating renal neoplasm: report of a case and review of the literature.
The Antopol-Goldman lesion is a subepithelial pelvic hematoma simulating a renal neoplasm. We report the clinico-pathological features of a single case and a review of the literature. A 76-year-old man presented with flank pain and hematuria. Computed tomography showed a hypodense lesion of 6 cm at the left kidney with filling defect at pyelogram. The patient underwent nephroureterectomy for suspected neoplasm. Macroscopically, a mass of 6 cm was present impinging on the pelvi-caliceal system. Microscopically, the lesion was composed by hemorragic material with feature of an hematoma. A diffuse eosinophilic amorphous material suspicious for amyloid was observed among intra- and extraparenchymal vessels. The Congo-Red staining verified the presence of amyloid. The diagnosis was subepithelial pelvic hematoma with severe amyloidosis. Antopol-Goldman lesion should be kept in mind as a possible differential diagnosis of upper urinary tract lesion to avoid unnecessary nephrectomies. The anamnestic knowledge of amiloydosis may increase this diagnostic hypothesis.
Eccher
Albino
A
Department of Pathology, Ospedale Civile Maggiore, Verona, Italy. albatax@libero.it
Brunelli
Matteo
M
Gobbo
Stefano
S
Ghimenton
Claudio
C
Grosso
Gaetano
G
Iannucci
Antonio
A
Dalla Palma
Paolo
P
Menestrina
Fabio
F
Martignoni
Guido
G
D000368:Aged; D000686:Amyloidosis / Q000150:complications / Q000473:pathology; D003937:Diagnosis, Differential; D006406:Hematoma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D007682:Kidney Pelvis / Q000473:pathology* / Q000601:surgery; D008297:Male; D009392:Nephrectomy; D014057:Tomography, X-Ray Computed