Endoscopic and histopathological features of gastrointestinal amyloidosis

Figure 1 Endoscopic view of amyloid light chains amyloidosis in a 64-year-old man without multiple myeloma presenting abdominal fullness. A: Characteristic multiple yellowish-white polypoid protrusions and thickening of the folds in the descending duodenum are presented; B: Biopsy specimens showed marked homogenous eosinophilic deposition in the mucosae and submucosa (HE, × 40); C: Congo red stain confirmed a unique “apple-green” birefringence of the amyloid deposition under polarized light (× 40). All figures and legends are reproduced from[8] with permission from Elsevier.

Figure 2 Endoscopic views of amyloid A amyloidosis in a 45-year-old woman with rheumatoid arthritis. A: A round ulcer surrounded by longitudinal reddish mucosa is presented in the gastric antrum. Histopathological examination confirmed amyloid deposition; B: Fine granular mucosa in the descending duodenum; C: Biopsy of the duodenal lesion showing marked amorphous eosinophilic deposition in the lamina propria mucosae (HE, × 100); D: Congo red staining showing amyloid deposition (× 100).

Figure 3 Endoscopic views of amyloid A amyloidosis in a 45-year-old man with familial Mediterranean fever. A: Friable granular mucosa with in the descending duodenum; B: Closer observation revealing whitish dilatated villi with multiple reddish erosions.

Figure 4 Endoscopic views of amyloid A amyloidosis in a 55-year-old man with familial Mediterranean fever. Patchy reddish mucosa was presented along with submucosal veins. Histopathological examination confirmed amyloid deposition.

Figure 5 Endoscopic views of amyloid light chains amyloidosis in an 80-year-old woman without multiple myeloma presenting hematochezia. A: Colonoscopy showing a round ulcer in the cecum; B: A patchy yellowish plaque-like infiltrative lesion (arrowheads) relatively normal-appearing intervening mucosae in the transverse colon; C: A tiny submucosal hematoma within pinky plaque-like erythema in the sigmoid colon; D: Biopsy of the colonic lesion showing marked amorphous eosinophilic deposition in the mucosa and submucosa (HE, × 100); E: Congo red staining showing amyloid deposition (× 100). All figures and legends are reproduced from[11] with permission from BMJ Publishing Group Ltd.