Vezikula Seminalis ve Duktus Deferens Yerleşimli Lokalize Amiloidozis Olgularının Retrospektif Analizi

Abstract

Amiloidoz, sistemik veya lokalize tutulum gösterebilen, amiloid proteinin ekstraselüler matrikste birikimi  ile karakterize heterojen bir hastalık grubudur. Lokalize amiloidoz, amiloid birikiminin tek bir dokuya sınırlı kalması sonucu gelişen ve lokalize bir kitle oluşturması nedeniyle de klinik olarak maligniteleri taklit edebilen non-neoplastik bir hastalıktır.  Bu çalışmada vezikula seminalis ve duktus deferens yerleşimli lokalize amiloidoz serimizin sunulması ve bu tümörlerin klinikopatolojik özelliklerinin literatür bilgileri eşliğinde sunulması amaçlanmıştır. Çalışmamızda Uludağ Üniversitesi Tıp Fakültesi Tıbbi Patoloji Anabilim Dalı arşivi taranarak 2013–2018 yılları arasında tanı almış vezikula seminalis ve duktus deferens yerleşimli lokalize amiloidoz olguları incelendi. Sistoprostatektomi prosedürü uygulanan 4 olguda sadece vezikula seminalislerde, prostatektomi prosedürü uygulanan 6 olgunun 5'inde hem vezikula seminalis hem de duktus deferenslerde ve 1 olguda ise sadece duktus deferenslerde lokalize amiloidoz saptandı. Olguların tamamında subepitelyal yerleşimli, eozinofilik, amorf, homojen madde şeklinde gözlenen birikimlere Kongo red boyaması uygulandı. Kongo red histokimyasal boyaması ile bu alanlarda kiremit kırmızısı boyanma saptandı ve polarize ışık mikroskobi bakısında elma yeşili refle verdiği tespit edildi. Sonuç olarak, lokalize amiloidoz çok farklı lokalizasyonlarda saptanabilmekle birlikte vezikula seminalis ve duktus deferens lokalizasyonunda nispeten nadirdir. İnsidental saptanmaları nedeniyle biyopsi örnekleri değerlendirilirken amiloid birikimi açısından da olguların değerlendirilmesi ve gerekli görülen olgularda Kongo red boyamasının yapılması önem arz etmektedir.

Keywords

• Duktus deferens,Genitoüriner sistem,Lokalize amiloidoz,Vezikula seminalis

A Retrospective Analysis of Cases with Localized Amyloidosis of the Vesicula Seminalis and the Ductus Deferens

Abstract

Amyloidosis is a heterogeneous group of diseases characterized by accumulation of amyloid protein in the extracellular matrix, which may be systemic or localized. Localized amyloidosis is a non-neoplastic disease that results from limited amyloid accumulation to a single tissue, and clinically mimics malignancies forming a localized mass. In this descriptive study, we aim to report our series of localized amyloidosis in the vesicula seminalis and the ductus deferens as well as clinicopathologic characteristics of these tumors in literature data. In this study, we examined the localized amyloidosis cases of the vesicula seminalis and the ductus deferens, diagnosed between 2013 and 2018 by searching the archives of Uludag University, Faculty of Medicine, Department of  Pathology. The sites where localized amyloidosis was detected include only the vesicula seminalis in four cases who underwent a cystoprostatectomy procedure, both the vesicula seminalis and the ductus deferens in five out of six cases with a prostatectomy procedure, and only the ductus deferens in one case. The deposits in the form of subepithelial, eosinophilic, amorphous and homogeneous substance were treated with Congo Red staining in all cases. The histochemical treatment with Congo Red yielded tile reddish staining in these areas, making them appear apple-green on the polarized light microscopy. In conclusion, localized amyloidoses are relatively rare in the vesicula seminalis and the ductus deferens, although they can be detected at very different locations. Since they are incidentally detected, it is important to evaluate a case in terms of amyloid deposits while examining biopsy specimens, as well as staining with Congo Red when necessary. 

Keywords

• Ductus deferens,genitourinary system,localized amyloidosis,vesicula seminalis

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