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Cholesterol crystal embolization diagnosed on bladder transurethral resection.

Denis Chatelain1, Carole Cordonnier, Marie Brevet

  • 1Department of Pathology, CHU Amiens, 80054 Amiens cedex 1, France. chatelain.denis@chu-amiens.fr

Annals of Diagnostic Pathology
|August 9, 2005
PubMed
Summary

Cholesterol crystal embolization (CCE) can affect the bladder, presenting unexpectedly during surgery for bladder tumors. This rare finding, diagnosed via transurethral resection, indicates severe atherosclerosis but may have a favorable prognosis.

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Area of Science:

  • Urology
  • Cardiovascular Pathology
  • Nephrology

Background:

  • Cholesterol crystal embolization (CCE) is a serious systemic condition arising from atherosclerotic plaque rupture.
  • CCE involves cholesterol crystal migration into smaller blood vessels, causing organ damage.
  • The bladder is an uncommon site for CCE diagnosis.

Observation:

  • Two male patients, aged 94 and 72 with atherosclerosis, were diagnosed with CCE during bladder transurethral resection.
  • Both patients had recent cardiovascular events or interventions.
  • Cystoscopy revealed bladder tumors; biopsies showed transitional cell carcinoma with cholesterol crystals in arterioles.

Findings:

  • Transitional cell carcinoma coexisted with CCE in the bladder wall arterioles.

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  • CCE in the bladder wall is a rare finding, with only 8 prior cases reported.
  • This diagnosis was incidentally discovered during tumor resection, not autopsy.

    • Implications:

    • CCE in the bladder wall may serve as a marker for widespread severe atherosclerosis.
    • Despite the severity of underlying disease, outcomes in these cases were favorable.
    • Early diagnosis through procedures like transurethral resection can aid patient management.