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Rare presentation of primary (AL) amyloidosis as gastrointestinal hemorrhage without systemic involvement

World Journal of Gastrointestinal Endoscopy 2014年第4期6卷 144-147页

作者： Mohammad F Ali Anik Patel Stephanie Muller David Friedel Department of Internal Medicine Winthrop University Hospital Department of Gastroenterology Hepatology and NutritionWinthrop University Hospital Department of Pathology Winthrop University Hospital

We are reporting a rare case of a patient with primary(AL) amyloidosis presenting with an acute non-varicealupper gastrointestinal hemorrhage in the absence ofother systemic involvement. The case report involves a58-year-old woman with significant cardiac history andhereditary blood disorder who came in complaining ofabdominal pain and coffee-ground emesis for two *** tomography(CT) scan of the abdomen andpelvis with contrast revealed segmental wall thickeningof the proximal jejunum with hyperdense, heterog-enous luminal content. Similar findings were evident inthe left lower small bowel region, suspicious for smallbowel hematoma and the possibility of intraluminalclots. Esophagogastroduodenoscopy performed postresuscitation showed punctate, erythematous lesionsthroughout the stomach as well as regions of smallbowel mucosa that appeared scalloped, ulcerated, andhemorrhaged on contact. Despite initial treatment for immunostain-positive focal cytomegalovirus gastritis, follow-up esophagogastroduodenoscopy after two months continued to demonstrate friable and irregular duodenal mucosa hinting at a different underlying etiol-ogy. Pathology reports from analyses of biopsy samples highlighted infiltration and expansion of the lamina pro-pria and submucosa. Subsequent staining with congo red/crystal violet and appropriate subtyping established the diagnosis of AL(kappa)-type amyloidosis. The sig-nificance of this case lies in the fact that our patient did not have the typically seen diagnostic systemic involvements-namely of heart and kidneys-usually seen in primary(AL) amyloidosis patients. It was the persis-tent endoscopic findings and biopsy results which gave clues to the physicians regarding the possibility of an abnormal protein-deposition entity.

关键词： Primary amyloidosis AL amyloidosis Gastrointestinal hemorrhage Endoscopic finding Endo-scopic biopsy Upper gastrointestinal bleeding Amyloid deposition Gastric/intestinal mucosa Mucosal inflammation

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Isolated Tracheobronchial amyloidosis

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International Journal of Clinical Medicine 2015年第9期6卷 643-645页

作者： Madiha Mahfoudhi Imen Gorsane Sami Turki Taieb Ben Abdallah Department of Internal Medicine A Charles Nicolle Hospital Tunis Tunisia

The tracheobronchial amyloidosis is a rarely localized form. It may manifest as a cancer. Only histological results allow diagnosis confirmation. A 68-year-old man was admitted for exploration of a low abundance hemoptysis. The chest radiograph was normal. CT scan objectified thickening of the walls of the trachea and bronchi which are the seat of calcifications. Bronchoscopy found a burgeoning infiltrative lesion training the right side face of the trachea and the anterior edge of the hull. Histological results confirmed tracheobronchial amyloidosis. Typing of this amyloidosis concluded to AL form. The study of amyloid extension lesion was negative. Immunoelectrophoresis of proteins in the blood and urine was normal. The patient was sent to receive external beam radiation to prepare for endoscopic surgical removal. Post-operative suites were marked by a complete resolution of clinical signs particularly hemoptysis with a follow-up of two years.

关键词： amyloidosis Trachea Biopsy

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Primary Laryngeal amyloidosis: A Case Report

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International Journal of Otolaryngology and Head & Neck Surgery 2017年第1期6卷 1-5页

作者： Devkumar Rengaraja Mohan Jagade Vitthal Kale Arpita Singhal Kiran Kulsange Karthik Rao Pallavi Gupta Radhika Sonate Amol Hekare Chinmayee Hebbar Department of ENT Grant Government Medical College and Sir JJ Groups of Hospital Mumbai India

amyloidosis is a benign, indolent condition which presents with an abnormal deposition of extracellular protein in various organs of the body. It usually presents with hoarseness of voice to an otolaryngologist. A sits clinical appearance mimics an early laryngeal cancer. It remains a diagnostic challenge to the clinician. It is essential to differentiate a primary laryngeal amyloidosis from malignancy to have a holistic approach towards the management of the disease. Here in this article, a case is reported in order to have a better outlook about this rare condition and to differentiate it from laryngeal malignancy for an effective management and cure.

关键词： Laryngeal amyloidosis Amyloid Localized amyloidosis

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An Interesting Case of Cardiac amyloidosis Initially Misdiagnosed as Syndrome X

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International Journal of Clinical Medicine 2011年第5期2卷 617-620页

作者： Hyung Rae Sohn Bong Gun Song Eun Jin Kim Seong Yeon Jeong Su-Min Hong Hyun Gul Jung Hye-Jin Jung Wook-Hyun Cho Suk-Koo Choi Division of Cardiology Cardiac and Vascular Center Department of Medicine Inje University Seoul Paik Hospital School of Medicine Inje University

Cardiac infiltration of amyloid fibril results in progressive cardiomyopathy with a grave prognosis and results in cardiac diseases such as congestive heart disease, cardiomyopathy, valvular heart disease, and arrhythmias. We present a rare case of cardiac amyloidosis initially misdiagnosed as syndrome X in which recurrent chest pain and progressive heart failure could be managed finally by heart transplantation.

关键词： Cardiac amyloidosis Syndrome X Heart Transplantation

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A Case Report of the Association Renal AA amyloidosis and Thyroid Papillary Carcinoma

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Open Journal of Nephrology 2018年第2期8卷 65-69页

作者： Dione Diomaye Jean Pierre Jmahri Hind En-Niya Fatima Al Hamany Zitouna Bouattar Tarik Benamar Loubna Bayahia Rabéa Ouzeddoun Naima Department of Nephrology Dialysis and Renal Transplantation Ibn Sina Hospital Rabat Morocco Laboratory of Pathology Children’s Hospital of Rabat Faculty of Medicine and Pharmacy of Rabat Mohammed V University Rabat Morocco

AA amyloidosis is often secondary to chronic inflammatory diseases but can rarely occur in patients with malignant neoplasms. A 33 years old woman with papillary carcinoma of thyroid was hospitalized in our department of Nephrology for nephrotic syndrome. Renal histology finds AA amyloidosis. To our knowledge, this is the first report of a patient with papillary carcinoma of thyroid and secondary (AA) amyloidosis with amyloid deposition in the kidneys causing nephrotic syndrome.

关键词： Papillary Carcinoma or Thyroid AA amyloidosis Nephrotic Syndrome

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Systemic amyloidosis presents a huge amyloidoma in the nasopharynx: A case report

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Journal of Medical Colleges of PLA(China) 2004年第3期19卷 194-196页

作者：镡旭民杨桦邓安春叶明福 Department of Otorhinolaryngology Xianqiao Hospital Third Military Medical University Department of Clinical Pathology Xianqiao Hospital Third Military Medical University

A tumor-like presentation of systemic amyloidosis in the nasopharynx is exceedingly rare. A male of 52-year-old with a recurrent mass in the nasopharynx underwent surgical resection 2 years ago. Immunohistochemical examination revealed M protein band and kappa immunoglobulin light chain. The sections of the biopsy of the mass in the nasopharynx and anterior abdominal wall were stained with Congo red and examined with microscopy. Amyloid deposits were found. It was diagnosed as systemic amyloidoma. Colchicine, melphalan and prednisone were administered. The mass decreased its size in the 8 months of follow-up. This case suggests that a solitary tumor in the nasopharynx might be an early sign of systemic amyloidosis because of the slow progression of the disease. The existence of a solitary amyloidoma in any location of the body should lead the doctor to look for other symptoms and signs of systemic amyloidosis.

关键词： amyloidosis solitary amyloidoma nasopharynx

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Rectal bleeding as a presenting symptom of AL amyloidosis and multiple myeloma

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World Journal of Gastrointestinal Endoscopy 2010年第1期2卷 44-46页

作者： Itay Maza Evgene Vlodavsky Rami A Eliakim Department of Gastroenterology Rambam Health Care CampusTechnion School of MedicineHaifa 31096Israel Department of Pathology Rambam Health Care CampusTechnion School of MedicineHaifa 31096Israel

amyloidosis of the gastrointestinal tract is a rare disease that presents with common,nonspecific signs and *** may affect any part of the gastrointestinal tract from mouth to *** clinical and endoscopic features are diverse and may mimic other diseases,such as inflammatory bowel disease,malignancy,ischemic colitis and,at times,collagenous *** describe an uncommon case of rectal bleeding and anemia with polypoid lesions and ulcerations in the colon,as the presenting symptom of AL amyloidosis and light chain multiple myeloma.

关键词： amyloidosis Multiple myeloma Colonic polyp Rectal bleeding

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Cardiac amyloidosis: The Role of Magnetic Resonance Imaging

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Open Journal of Clinical Diagnostics 2014年第1期4卷 27-30页

作者： Linda Sim Christopher Semsarian David Celermajer Rajesh Puranik Department Cardiology Royal Prince Alfred Hospital Sydney Australia

amyloidosis, an infiltrative disease characterized by deposition of high molecular weight insoluble protein has a low detection rate and poor prognosis with congestive heart failure being the most common cause of death. Although definitive diagnosis is based on endomyocardial biopsy, this is rarely performed due to procedural risk and sampling error. Traditional non-invasive imaging, such as transthoracic echocardiography (TTE) and electrocardiogram (ECG) lacks sensitivity detecting the disease in its early stages. This case report demonstrates the utility of cardiac Magnetic Resonance Imaging in addition to traditional imaging modalities in this often clinically challenging problem.

关键词： Cardiac amyloidosis Cardiac Magnetic Resonance Imaging (CMR) Transthoracic Echocardiography (TTE) Electrocardiography (ECG) Congestive Cardiac Failure (CCF)

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Echocardiographic features of an atypical presentation of rapidly progressive cardiac amyloidosis

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World Journal of Cardiology 2013年第5期5卷 154-156页

作者： Jasper J Brugts Jaco Houtgraaf Bouke PC Hazenberg Marcel JM Kofflard Department of Cardiology Albert Schweitzer hospital 3300 AK Dordrecht The Netherlands Department of Cardiology University Medical Center Groningen 9700 RB Groningen The Netherlands

We present the case of a 66 year old male who presented with dyspnea and reduced exercise tolerance. Echocardiography demonstrated impaired left ventricular (LV) function and restrictive diastolic function with pronounced concentric left ventricular hypertrophy (LVH) without a history of hypertension and no aortic valve stenosis. Differential diagnostics of concentric LVH are discussed in detail. In the current case, cardiac amyloidosis (AL) amyloidosis was diagnosed and confirmed by serum amyloid P (SAP) scintigraphy and abdominal fat aspiration biopsy. This case shows the rapid decline in clinical condition with progression of cardiac involvement of AL. As discussed in detail, cardiac involvement in AL-amyloidosis generally denotes a poor prognosis, regardless of the method of treatment.

关键词： amyloidosis Cardiac involvement Echocar diography Treatment Prognosis

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Breast amyloidosis:a case report

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Plastic and Aesthetic Research 2016年第1期3卷 240-244页

作者： Giulia Boscaini Marco Pignatti Giovanni Tazzioli Giorgio De Santis Department of Plastic Reconstructive and Aesthetic SurgeryAzienda Ospedaliero Universitaria Policlinico di Modena41124 ModenaItaly

amyloidosis is an uncommon disorder characterized by extracellular deposition of abnormal *** involvement has rarely been reported and can clinically be misdiagnosed as breast cancer.A 60-year-old woman presented with a 3-mm diameter mass in the right breast close to a silicon implant positioned 20 years before.A core biopsy,performed to rule out breast cancer,showed amyloid *** exams confirmed a systemic amyloid light chain *** few months the mass increased causing breast volume and shape *** breast cancer may be the cause of amyloid deposits or be hidden by it,the patient underwent a bilateral skin sparing mastectomy and expander and fat grafting breast *** resection specimens showed amyloid deposits only,no evidence of *** 2 years follow-up,no breast amyloidosis recurrence was *** amyloidosis is rare but can occur in a plastic surgeon’s *** is mandatory to rule out a comitant breast cancer or systemic amyloidosis.

关键词： amyloidosis breast amyloidosis breast cancer breast reconstruction

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