Primary amyloidosis of the urinary bladder presenting as painless heamaturia

The purpose of this case report is to create awareness among the urologists to think for the rare entity of urinary amyloidosis especially if the histopathology is negative for the malignancy. A case of primary amyloidosis of urinary bladder was presented with painless heamaturia and irritative urinary symptoms. Radiological imaging showed multiple small masses within the urinary bladder with suspicion of transitional cell carcinoma. Cystoscopy confirmed the multiple masses within the urinary bladder, some showing haemorrhagic papules and papillary projections over the masses. Histopathology of the biopsy material was negative for malignancy. Immunohistchemical staining with Congo red stain showed the presence of amyloid fibrils within the biopsy material. Further investigations of systemic illness exclude secondary amyloidosis. Transurethral resection was done. Patient showed improvement after the resection and no recurrence was observed during follow up.