POLYPOID MULTIFOCAL ILEO-COLONIC AMYLOIDOMA MASQUERADING MALIGNANCY - A RARE CASE REPORT

Aniket Halder, R. Ghosh, S. Ray
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Abstract

Amyloidosis is a group of disorders characterized by extracellular deposition of a proteinaceous homogenous eosinophilic hyaline substance known as amyloid. Congo red staining is a specific stain for amyloid which shows an apple-green birefringence on polarized microscopy. Amyloid deposition can be systemic or localized. Primary amyloidosis (also known as AL amyloidosis) is the most common form of amyloidosis characterized by generalized deposition of excess immunoglobulin light chains. It is associated with an underlying plasma cell dyscrasia and has the maximum gastrointestinal (GI) involvement. Secondary amyloidosis is characterized by deposition of acute-phase reactant - serum amyloid A protein (also known as AA amyloidosis) and it is associated with infectious, inflammatory, or less commonly, neoplastic disorders. Renal dysfunction is the most common symptom of AA amyloidosis at diagnosis. Amyloidosis presenting as a localized mass is known as amyloidoma. Amyloidoma of the GI system is a rare finding in the absence of any systemic involvement. We report a rare case of localized multifocal polypoid amyloidoma in the lower GI tract, which masquerades as malignancy.
伪装恶性息肉样多灶性回结肠淀粉样瘤1例
淀粉样变性是一组疾病,其特征是细胞外沉积一种称为淀粉样蛋白的均匀的嗜酸性透明物质。刚果红染色是淀粉样蛋白的特异性染色,在偏振显微镜下显示苹果绿双折射。淀粉样蛋白沉积可以是全身性的,也可以是局部的。原发性淀粉样变性(也称为AL淀粉样变性)是最常见的淀粉样变性,其特征是过量免疫球蛋白轻链的广泛性沉积。它与潜在的浆细胞病变有关,并最大程度地累及胃肠道(GI)。继发性淀粉样变性的特征是急性期反应物-血清淀粉样蛋白A的沉积(也称为AA淀粉样变性),它与感染性、炎症性或不太常见的肿瘤性疾病有关。肾功能不全是AA淀粉样变最常见的诊断症状。淀粉样变性表现为局部肿块,称为淀粉样瘤。胃肠道淀粉样瘤是一种罕见的发现,没有任何系统的累及。我们报告一例罕见的下消化道局部多灶性息肉样淀粉样瘤,其伪装为恶性肿瘤。
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