Primary amyloidosis of the bladder

A 39 year old Caucasian male presented with a 10 day history of visible painless haematuria. He had one previous episode of haematuria ten months prior to this following ozone therapy for Lyme's disease. His past medical history included alopecia and chronic fatigue syndrome. He took no regular medications. There were no risk factors for transitional cell carcinoma (TCC) of the bladder. An ultrasound scan of the urinary tract did not demonstrate any renal masses and there was a smooth walled bladder. Flexible cystoscopy demonstrated multiple raised haemorrhagic lesions in the dome of the bladder and malignancy was suspected. A subsequent CT urogram showed a thickened anterior-superior bladder