Abstract
Introduction
Amyloidosis could be primary (AL), reactive (secondary), dialysis related and senile systemic.
Amyloidosis (A) of the gastrointestinal tract, with biopsy-proved disease, is rare. Patients with systemic immunoglobulin-chain A can be treated with anti-plasma cell therapy (A.Cowan et al., 2013). Usually gastric and esophageal A is a part of systemic form in 80-90 % of cases, in 60% it is reactive, but gastric amyloid deposits occur in ~ 1% of patients with systemic amyloidosis (A.Shtnawei et al., 2009).
Gastrointestinal amyloidosis results from either mucosal or neuromuscular infiltration (C.FenoglioPreiser at al., 2008). Disease is characterized by abnormal presence of fibrillary proteins in one or more organs' extracellular spaces, causing structural and functional organ damage (N. Sangle et al., 2011).
Study Aims To demonstrate rare pathology of stomach and esophagus in young patient with diffuse lymphoma.
Methods
Biopsies were stained with haematoxylin and eosin, Gimza and Congo-red methods. Immunohistochemistry was done with kappa, lambda, vimentin, CD5, bcl2, LCA, CD20, CD56, CK Ae1/3, Ki67 antibodies by EnVision method.
Results
30 years young female was hospitalized at Riga East Clinical University Hospital’s Chemotherapy and Hematology Clinic with thoracalgia, swelling of neck. Compressive v. cava superior and enlargement of mediastinal lymph nodes was diagnosed. An endoscopy detected a granular appearance of gastric mucosa and small scars and tiny elevated areas (2-3 mm Ø) in esophagus. Gastric biopsy revealed pail eosinophilic, Congo red-positive amyloid deposits around small vessels and between atrophic glands
with mild chronic gastritis of low its activity. In biopsy specimens from the esophagus we have proved amyloid aggregates (Congo red +) and erosions with chronic active inflammation around them. Biopsy of lymph node proved diffuse large cell B lymphoma, centroblastic variation with immunphenotype: CD5-, bcl2 only patchy+, LCA+, CD20+, CD56-, CK Ae1/3-and Ki67-55%. Patient has received chemotherapy and irradiation treatment.
Conclusions
As gastric amyloidosis is rare pathology, we wanted to pay colleagues attention to this possible complication of large cell lymphoma. Clinicians should be aware of the possible gastrointestinal involvement by different types of amyloidosis.
Amyloidosis could be primary (AL), reactive (secondary), dialysis related and senile systemic.
Amyloidosis (A) of the gastrointestinal tract, with biopsy-proved disease, is rare. Patients with systemic immunoglobulin-chain A can be treated with anti-plasma cell therapy (A.Cowan et al., 2013). Usually gastric and esophageal A is a part of systemic form in 80-90 % of cases, in 60% it is reactive, but gastric amyloid deposits occur in ~ 1% of patients with systemic amyloidosis (A.Shtnawei et al., 2009).
Gastrointestinal amyloidosis results from either mucosal or neuromuscular infiltration (C.FenoglioPreiser at al., 2008). Disease is characterized by abnormal presence of fibrillary proteins in one or more organs' extracellular spaces, causing structural and functional organ damage (N. Sangle et al., 2011).
Study Aims To demonstrate rare pathology of stomach and esophagus in young patient with diffuse lymphoma.
Methods
Biopsies were stained with haematoxylin and eosin, Gimza and Congo-red methods. Immunohistochemistry was done with kappa, lambda, vimentin, CD5, bcl2, LCA, CD20, CD56, CK Ae1/3, Ki67 antibodies by EnVision method.
Results
30 years young female was hospitalized at Riga East Clinical University Hospital’s Chemotherapy and Hematology Clinic with thoracalgia, swelling of neck. Compressive v. cava superior and enlargement of mediastinal lymph nodes was diagnosed. An endoscopy detected a granular appearance of gastric mucosa and small scars and tiny elevated areas (2-3 mm Ø) in esophagus. Gastric biopsy revealed pail eosinophilic, Congo red-positive amyloid deposits around small vessels and between atrophic glands
with mild chronic gastritis of low its activity. In biopsy specimens from the esophagus we have proved amyloid aggregates (Congo red +) and erosions with chronic active inflammation around them. Biopsy of lymph node proved diffuse large cell B lymphoma, centroblastic variation with immunphenotype: CD5-, bcl2 only patchy+, LCA+, CD20+, CD56-, CK Ae1/3-and Ki67-55%. Patient has received chemotherapy and irradiation treatment.
Conclusions
As gastric amyloidosis is rare pathology, we wanted to pay colleagues attention to this possible complication of large cell lymphoma. Clinicians should be aware of the possible gastrointestinal involvement by different types of amyloidosis.
| Original language | English |
|---|---|
| Pages | 57 -57 |
| Number of pages | 1 |
| Publication status | Published - 2013 |
| Event | VI Latvian Gastroenterology Congress with International participation: Gastroenterology in the world and Latvia: Science for practice - RSU, Riga, Latvia Duration: 7 Dec 2013 → 7 Dec 2013 Conference number: 6 https://www.rsu.lv/sites/default/files/book_download/Abstracts_from_VI_Latvian_Gastroenterology_Congress.pdf |
Congress
| Congress | VI Latvian Gastroenterology Congress with International participation |
|---|---|
| Country/Territory | Latvia |
| City | Riga |
| Period | 7/12/13 → 7/12/13 |
| Internet address |
Keywords*
- Amyloidosis
- stomach
- oesophagus
- Histology
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)