THE UNMASKING OF AMYLOID

Abstract

Introduction: Amyloidosis was first described by Virchow. Early detection of amyloidosis is essential as there are effective treatments for the primary causes. The progression and severity of the disease can be halted with newer treatments. The cause of amyloidosis often remains elusive. Amyloidosis is usually incidentally detected in biopsies.

Aim: We aim to evaluate the clinical features and histomorphological findings and document the occurrence of rare presentations of amyloidosis.

Materials and methods: The cases documented as organ amyloidosis were collected from the casefiles and records. The amyloidosis associated with skin and neoplastic lesions are excluded. The histopathological slides and congored stained slides were reviewed with analysis of the microscopic features. Polarizing microscopy was performed to confirm the diagnosis.

Results: These included a total of 14 cases. Three cases of larynx, two each of peripheral nerves and abdominal fat, along with one each of heart, gastric, duodenum, colon, liver, pancreas and spleen are included in the study. The age range was 35 years to 84 years. The median age was 62 years. Male predominance (71%) was noted. Most common organ involved in the present series was larynx.

Conclusion: This is a review of the rare cases of amyloidosis which had unusual presentation and histopathology finally revealed the diagnosis. High suspicion of amyloidosis can help in early diagnosis. Careful histomorphological analysis recognizes the patterns in which this disease entity can present, so that early lesions can also be subjected to special staining with congo red and polarized microscopy for early treatment and to minimize complications and morbidity.