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Pathology of Human Bladder Cancer and Related Lesions
Published in George T. Bryan, Samuel M. Cohen, The Pathology of Bladder Cancer, 2017
Gilbert H. Friedell, George K. Nagy, Samuel M. Cohen
Amyloidosis of the bladder may be secondary to chronic inflammatory processes or multiple myeloma or it may be primary.97 The primary form consists of either solitary or multiple nodules in the submucosa or these lesions may be present in the stalk of polyps. The primary lesion usually presents as microhematuria, and the lesion may hemorrhage severely if biopsied.98 The primary lesion usually appears as extracellular deposits of typical amyloid material and foreign body giant cells may surround these. Secondary amyloidosis usually occurs as deposits of the amyloid in the walls of blood vessels, markedly thickened by the amyloid. Foreign body giant cells may be present but plasma cell infiltrates have not been recorded in the bladder in these lesions.
Chronic Prostatitis/Chronic Pelvic Pain Syndrome—A Urologist’s Perspective
Published in Gary W. Jay, Practical Guide to Chronic Pain Syndromes, 2016
Richard A. Watson, Hossein Sadeghi-Nejad
Voided urine cytologies, while not routine, should be readily considered whenever the index of suspicion is at all elevated—for instance, patients who either have had a long history of smoking, or have had occupational exposure to known toxins, or exhibit persistent microhematuria. When such a patient is undergoing cystoscopy, bladder-wash cytology may be obtained. Carcinoma in situ of the bladder (CIS) may resemble normal epithelium or appear as an erythematous, velvety patch of mucosa (1).
Viral Infections and the Kidney: A Major Problem in Developing Countries
Published in Meguid El Nahas, Kidney Diseases in the Developing World and Ethnic Minorities, 2005
M. Rafique Moosa, Theo L. Hattingh, William D. Bates
Mesangiocapillary GN has also been reported in carriers of HBsAg, although not as frequently as MGN (194,216,232). Several studies have noted that both adults and children with mesangiocapillary GN have a markedly higher carrier rate of HBsAg than the general population (202,232,233). The usual pattern of HBV-MGN often has mesangiocapillary elements (sub-endothelial deposits and mesangial interposition) and these could cause diagnostic difficulty and overlap. Patients present with nephritic syndrome and microhematuria (194). In one series, hypertension was reported in 45% and renal insufficiency in 20% (232). In our series of 36 HBV adult patients, five showed mesangiocapillary GN (14%), compared to 33% with MGN. Mesangial proliferative GN, with increased mesangial cell hypercellularity and deposition of IgG and/or IgM, has also been documented (194,204). Other forms of glomeruloneophritis, including IgA and systemic lupus erythematosis have been reported to be more frequent in HBV carriers, but these associations remain controversial (234–236).
Bilateral orbital granulomatosis with polyangiitis complicated by central serous chorioretinopathy
Published in Clinical and Experimental Optometry, 2022
Anand D Gopal, Austin Meeker, Sathyadeepak Ramesh
Diagnostic criteria set by the American College of Rheumatology require two or more of the following for diagnosis of GPA with a sensitivity of 88.2% and a specificity of 92.0%: 1) nasal or oral inflammation; 2) abnormal chest imaging with the presence of nodules, fixed infiltrates, or cavities; 3) urine sediment demonstrating microhematuria or red blood cell casts; and 4) granulomatous inflammation on biopsy.5 As the clinical features of orbital GPA are relatively non-specific, they may be difficult to differentiate from other aetiologies of orbital inflammation, delaying a diagnosis. Evidence suggests that among patients with orbital inflammation, the presence of sinonasal symptoms or imaging demonstrating bony erosion or sinonasal changes is most predictive of GPA.6 Biopsy is often helpful in corroborating a diagnosis, but histopathologic findings may be non-specific and must be interpreted in the context of clinical and serologic data. Classic biopsy findings in orbital GPA include vasculitis, necrosis, and granulomatous mixed acute and chronic inflammation with or without giant cells,7 though this triad occurs in only 54% of orbital biopsies.8
Relapsing polychondritis: state-of-the-art review with three case presentations
Published in Postgraduate Medicine, 2021
Bogna Grygiel-Górniak, Hamza Tariq, Jacob Mitchell, Azad Mohammed, Włodzimierz Samborski
In terms of the renal system, involvement may be rare and occurs later in the disease[6]. According to Borgia et al. [28], renal lesions may occur in approximately 22% of RPC patients, occurring with microhematuria and/or proteinuria[28]. The most common symptom is mesangial proliferation, as well as segmental necrotizing glomerulonephritis. Less commonly, cases of immunoglobulin A nephropathy and tubulointerstitial nephritis have been reported in patients with RPC. [26,27,35,45] According to Borgia et al. [28], immunofluorescence microscopy of the kidney shows immunoglobulins A, G, and M and complement deposits in the basement membrane, capillary walls, and mesangium. This may suggest that these immune complexes play a part in the pathogenesis of relapsing polychondritis lesions[28].
Low accuracy of microscopic hematuria in detecting coagulopathy from Bothrops pit viper bites, Brazilian Amazon
Published in Clinical Toxicology, 2019
Jose Diego de Brito Sousa, Sâmella Silva de Oliveira, Jacqueline Sachett, Hui Wen Fan, Wuelton Marcelo Monteiro
Our results show that a patient with microhematuria is 82.1% more likely to have developed hypofibrinogenemia. However, all diagnostic parameters, but the positive predictive value, were low, indicating that a more reliable tool is still needed to accurately diagnose consumption coagulopathy. Additionally, fibrinogen levels and an absolute number of red blood cells in urine showed no significant association. Although the reliability of bedside clotting tests such as the LWCT depends on several factors in the clinical practice, they still represent a better diagnostic tool in Bothrops envenomation [2,4]. One speculates that hematuria may be more related to vascular endothelium injury caused by metalloproteinases rather than consumption coagulopathy, which could explain our results. Indeed, a PI metalloproteinase called batroxase, isolated from B. atrox venom, has fibrinolytic, thrombolytic activities and induces weak bleeding through the digestion of the extracellular matrix components such as laminin, type IV collagen and fibronectin [9]. The batroxrhagin, a PIII metalloproteinase isolated from B. atrox venom, also induces bleeding [10], as well as atroxlysin I, a PI metalloproteinase [11].