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

Department of Pathology, Ospedale Civile Maggiore, Verona, albatax{at}libero.it, Department of Pathology, Università di Verona, Verona

Matteo Brunelli, MD

Department of Pathology, Università di Verona, Verona

Stefano Gobbo, MD

Department of Pathology, Università di Verona, Verona

Claudio Ghimenton, MD

Department of Pathology, Ospedale Civile Maggiore, Verona

Gaetano Grosso, MD

Urology Unit, Casa di Cura Pederzoli, Peschiera

Antonio Iannucci, MD

Department of Pathology, Ospedale Civile Maggiore, Verona

Paolo Dalla Palma, MD

Department of Pathology, Ospedale S. Chiara, Trento Italy

Fabio Menestrina, MD

Department of Pathology, Università di Verona, Verona

Guido Martignoni, MD

Department of Pathology, Università di Verona, Verona

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.

Key Words: Antopol—Goldman lesion • subepithelial pelvic hematoma • renal neoplasm • filling defect • amyloidosis

This version was published on June 1, 2009

International Journal of Surgical Pathology, Vol. 17, No. 3, 264-267 (2009)
DOI: 10.1177/1066896908330482


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