原发性局限性输尿管淀粉样变性1例

邹燕丽; 张雨涛

doi:10.3969/j.issn.1007-8096.2023.06.039

摘要：患者,男性,50岁.因无明显诱因出现左侧腰部酸胀及疼痛10余天入院.专科检查左肾区轻度叩击痛,输尿管区无明显压痛. 入院后在全麻下行"左侧输尿管镜检查+经输尿管镜左输尿管扩张术+左输尿管活检术+经输尿管镜输尿管支架置入术",术中见左侧输尿管开口区域隆起呈息肉状和滤泡状增生,触之易出血,壁内段狭窄,狭窄段长约5 mm,并可见大量黄白色物附着及2 mm的细小钙化灶,周围黏膜充血水肿,余未见特殊,钳取少许狭窄段组织送病理活检. [1]Sipe JD,Cohen AS.Review:history of the amyloid fibril[J].J Struct Biol,2000,130(2-3):88-98. [2]U-N.里德,M.维尔纳,H-E.舍费尔.里德病理学[M].武忠弼,译.上海:上海科学技术出版社,2007:44-48. [3]Sipe JD,Benson MD,Buxbaum JN,et al.Nomenclature committee of the international society of amyloidosis.Amyloid fibril protein nomenclature:2012 recommendations from the nomenclature committee of the international society of amyloidosis[J].Amyloid,2012,19(4):167-170. [4]Monge M,Chavveav D,Cordonnier C,et al.Localized amyloidosis of the genitourinary tract:report of 5 new cases and review of the literature[J].Medicine(Baltimore),2011,90(3):212-222. [5]Hanna DN,Levy JA,Marshall JS.Amyloidosis and acute hemorrhage of the kidney,ureter,and bladder[J].Can J Urol,2017,24(4):8934-8936. [6]Wes termark P.Localized AL amyloidosis:a suicidal neoplasm?[J]Ups J Med Sci,2012,117(2):244-250. [7]Ezawa N,Katoh N,Oguchi K,et al.Visualization of multiple organ amyloid involvement in systemic amyloidosis using 11C-PiB PET imaging[J].Eur J Nucl Med Mol Imaging,2018,45(3):452-461. [8]García Rojo E,González Padilla DA,Castelo Loureiro A,et al.New case of secondary bladder amyloidosis with massive hematuria-role of intravesical instillations with dimethyl sulfoxide[J].Transl Androl Urol,2019,8(5):548-555. [9]Fushimi T,Takei Y,Touma T,et al.Bilateral localized amyloidosis of the ureters:clinicopathology and therapeutic approaches in two cases[J].Amyloid,2004,11(4):260-264.