Subepithelial Pelvic Hematoma (Antopol—Goldman Lesion) Simulating Renal Neoplasm: Report of a Case and Review of the Literature

The Antopol-Goldman lesion is a subepithelial pelvic hematoma simulating a renal neoplasm. We report the clinico-pathological features of a single case and a review of the literature. A 76-year-old man presented with flank pain and hematuria. Computed tomography showed a hypodense lesion of 6 cm at the left kidney with filling defect at pyelogram. The patient underwent nephroureterectomy for suspected neoplasm. Macroscopically, a mass of 6 cm was present impinging on the pelvi-caliceal system. Microscopically, the lesion was composed by hemorragic material with feature of an hematoma. A diffuse eosinophilic amorphous material suspicious for amyloid was observed among intra- and extraparenchymal vessels. The Congo-Red staining verified the presence of amyloid. The diagnosis was subepithelial pelvic hematoma with severe amyloidosis. Antopol-Goldman lesion should be kept in mind as a possible differential diagnosis of upper urinary tract lesion to avoid unnecessary nephrectomies. The anamnestic knowledge of amiloydosis may increase this diagnostic hypothesis.

[1]  P. Duffau,et al.  Lésion d'Antopol-Goldman : une cause rare d'hématurie , 2005 .

[2]  M. Gutiérrez,et al.  Hematoma subepitelial de la pelvis renal como causa de defecto de repleción en el estudio radiológico del tracto urinario superior , 2005 .

[3]  F. Basseau,et al.  [Antopol-Goldman lesion: a rare cause of hematuria]. , 2005, Nephrologie & therapeutique.

[4]  M. O. Ortiz Gorraiz,et al.  [Subepithelial hematoma of the renal pelvis producing a filling defect in the upper urinary tract radiological study]. , 2005, Archivos espanoles de urologia.

[5]  J. Nicoll,et al.  Cerebral amyloid angiopathy and thrombolysis-related intracerebral haemorrhage , 2004, The Lancet Neurology.

[6]  A. Alonso,et al.  Hematoma subepitelial de pelvis renal y uréter: lesión de antopol-goldman , 2002 .

[7]  S. Boorjian,et al.  A rare case of painless gross hematuria: primary localized AA-type amyloidosis of the urinary bladder. , 2002, Urology.

[8]  A. Rodríguez Alonso,et al.  [Subepithelial hematoma of kidney pelvis and ureter: Antopol-Goldman lesion]. , 2002, Actas urologicas espanolas.

[9]  I. Soomro,et al.  Vascular amyloidosis causing spontaneous mediastinal haemorrhage with haemothorax. , 2001, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[10]  P. Hawkins,et al.  Bleeding symptoms and coagulation abnormalities in 337 patients with AL‐amyloidosis , 2000, British journal of haematology.

[11]  F. Rubio,et al.  Hemorragia subepitelial de pelvis renal (lesión de Antopol-Goldman). Presentación de cuatro casos y revisión de la literatura. , 2000 .

[12]  G. Palladini,et al.  Clotting alterations in primary systemic amyloidosis. , 2000, Haematologica.

[13]  Demirkan,et al.  Subepithelial haematoma of the renal pelvis (Antopol–Goldman lesion) , 1999, Histopathology.

[14]  H. Lui,et al.  Excess tissue friability during CO2 laser vaporization of nodular amyloidosis. , 1999, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[15]  D. Bostwick,et al.  Subepithelial pelvic hematoma of the kidney clinically mimicking cancer: report of six cases and review of the literature. , 1999, Urology.

[16]  H. Ahn,et al.  Subepithelial hematoma of the renal pelvis simulating neoplasm (Antopol-Goldman lesion). , 1997, Urologia internationalis.

[17]  R. Moser,et al.  Subepithelial hematoma of the renal pelvis (Antopol-Goldman lesion) , 1996, The Journal of urology.

[18]  R. Kyle,et al.  Primary systemic amyloidosis: clinical and laboratory features in 474 cases. , 1995, Seminars in hematology.

[19]  K. Muroi,et al.  Bleeding tendency caused by the deposit of amyloid substance in the perivascular region. , 1993, Internal medicine.

[20]  T. Ekfors,et al.  Secondary amyloidosis of the bladder: a cause of massive hematuria. , 1987, The Journal of urology.

[21]  J. Dekernion,et al.  Subepithelial hematoma of the renal pelvis (Antopol-Goldman lesion): a case report and review of the literature. , 1984, The Journal of urology.

[22]  M. Skinner,et al.  Bleeding manifestations in 100 patients with amyloidosis. , 1983, JAMA.

[23]  M. Viamonte,et al.  Subepithelial hemorrhage of renal pelvis simulating neoplasm (Antopol-Goldman lesion). , 1980, Urology.

[24]  L. Orkin,et al.  Subepithelial hemorrhage of renal pelvis simulating neoplasm (Antopol-Goldman lesion). , 1972, The Mount Sinai journal of medicine, New York.

[25]  W. Antopol,et al.  Subepithelial hemorrhage of renal pelvis simulating neoplasm. , 1948, The Urologic and cutaneous review.