Abstract
A 75-year-old man, who presented to the Department of Urology in our hospital because of painless intermittent gross hematuria, was diagnosed with multiple bladder cancer. He was indicated to have an abnormal shadow on a chest radiograph during medical examinations. A chest CT scan revealed a nodular shadow 2 cm in diameter in the right lung (S6). Metastatic lung cancer was suspected and he was referred to our department. Since the therapeutic tactics depended on whether the tumor was metastasis from bladder cancer or not, we performed video-assisted right partial pneumonectomy for diagnosis. The histopathological diagnosis was AL type amyloidosis. Finally we diagnosed his illness as localized nodular pulmonary amyloidosis, because there was no evidence of amyloid deposition in other organs and general exploration deneyed association of multiple myeloma. The patient's postoperative course was uneventful. To our knowledge, only one case of bladder cancer associated with pulmonary amyloidosis has previously been reported. Some authors reported an association between cancer and pulmonary amyloidosis, mainly AA type secondary amyloidosis. However in this case it was the AL type. We're not sure whether there is a causal relationship between localized nodular amyloidosis and bladder cancer. Localized nodular amyloidosis with bladder cancer is very rare, and then further studies are required. We present this case of localized nodular pulmonary amyloidosis in which the disease was detected during close inspection for bladder cancer and a possibility of relation with bladder cancer could not be ruled out.
