leuprolide and Amyloidosis

Localized seminal vesicle amyloidosis is an unusual finding in surgical pathology material. Previous studies have demonstrated that the amyloid is directly produced by the seminal vesicle epithelial cells. We investigated the possible association of seminal vesicle amyloid in patients hormonally treated for prostate carcinoma.. Cases were collected from over 200 prostate needle biopsies, seminal vesicle biopsies, and prostatectomy specimens from the surgical pathology files at The Mount Sinai Hospital, New York, NY. None of the patients with seminal vesicle amyloidosis had a chronic inflammatory disorder, serum or urine protein abnormalities, or other identifiable masses.. Six cases of localized seminal vesicle amyloidosis were found in the surgical pathology material examined. Five of the six cases had prostatic carcinoma, and one case was seen in a biopsy for benign prostatic hyperplasia. Four of the five carcinoma cases had prior hormonal treatment (luteinizing hormone-releasing hormone agonist with an antiandrogen agent, and one patient, in addition, had received radiotherapy). The amyloid deposits were limited to the seminal vesicle lamina propria without involvement of vascular walls. The amyloid reacted with Congo red staining that was sensitive to potassium permanganate. Immunohistochemically, all cases were negative for AA amyloid, beta 2-microglobulin, and kappa and lambda light chains.. We raise the possibility that in some instances, prior hormonal therapy may act as a seminal vesicle epithelial stimulant for the elaboration of this protein.

Topics: Adenocarcinoma; Aged; Amyloidosis; Androgen Antagonists; Antineoplastic Agents, Hormonal; beta 2-Microglobulin; Biopsy; Drug Therapy, Combination; Epithelial Cells; Flutamide; Gonadotropin-Releasing Hormone; Humans; Immunoglobulin gamma-Chains; Immunoglobulin kappa-Chains; Immunohistochemistry; Leuprolide; Male; Middle Aged; Prostatic Neoplasms; Proteinuria; Seminal Vesicles; Serum Amyloid A Protein; Testicular Diseases