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Presented by Ralph Hruban, M.D. and prepared by Jeffrey Seibel, M.D. Ph.D.
Case 1: 61 year old female with GI bleeding.
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1. Question
Week 77: Case 1
61 year old female with GI bleeding./images/021002case1a.jpg
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/images/021002case1d.jpgCorrect
Answer: Amyloidosis
Histology: This biopsy reveals the deposition of amorphous eosinophilic material in the lamina propria and in small vessels. The material stains pink-red with the congo red stain and produces the characteristic apple-green birefringence when observed by polarizing microscope (not shown).
Discussion: Amyloid is an abnormal proteinaceous material deposited between cells. By light microscopy, amyloid appears as an amorphous “waxy” pink material. At the electron microscopic level one sees non-branching 7.5 – 10 nm fibrils. A variety of diseases can result in the deposition of amyloid. The two most common causes include: A) Multiple myeloma which can result in the deposition of immunoglobulin light chains (called AL) in a variety of organs. B) Chronic diseases, including Rheumatoid arthritis and Crohns Disease, which can be complicated by the deposition of amyloid derived from serum amyloid-associated protein (AA).
Incorrect
Answer: Amyloidosis
Histology: This biopsy reveals the deposition of amorphous eosinophilic material in the lamina propria and in small vessels. The material stains pink-red with the congo red stain and produces the characteristic apple-green birefringence when observed by polarizing microscope (not shown).
Discussion: Amyloid is an abnormal proteinaceous material deposited between cells. By light microscopy, amyloid appears as an amorphous “waxy” pink material. At the electron microscopic level one sees non-branching 7.5 – 10 nm fibrils. A variety of diseases can result in the deposition of amyloid. The two most common causes include: A) Multiple myeloma which can result in the deposition of immunoglobulin light chains (called AL) in a variety of organs. B) Chronic diseases, including Rheumatoid arthritis and Crohns Disease, which can be complicated by the deposition of amyloid derived from serum amyloid-associated protein (AA).
