Amyloidosis

Question 1

Systemic amyloidosis can occur in patients w what disease?

Answer 1

multiple myeloma and Bcell dyscrasia

Question 2

Skin lesions.

Answer 2

Smooth, waxy papules (also nodules on the face, especially around
the eyes. can have pinch lesions.

Question 3

Prediliction sites.

Answer 3

sites are around the eyes, central face, extremities, body folds, axillae, umbilicus, and anogenital area

Question 4

Tongue presentation.

Answer 4

Macroglossia : diffuse large woody.

Question 5

Laboratory:

Answer 5

thrombocytosis > 500,000/μL. Proteinuria
increased serum creatinine hypercalcemia.
Increased IgG
Bone marrow: myeloma.

Question 6

Dermatopath

Answer 6

Accumulation of faintly eosinophilic masses of amyloid in the papillarybody near the epidermis, in the papillary and reticular dermis, in sweat glands, around and within blood vessel walls.

Immunohistochemistry to assess the proportion of kappa and lambda lightchains

Question 7

Localized cutaneous amyloidosis.

Give the 3 varieties.

Answer 7

Nodular amyloidosis: Single or multiple, smooth, nodular lesions with or without purpura on the limbs, face, or trunk
■ Lichenoid amyloidosis: Discrete, very pruritic, brownish-red papules on the legs (Fig. 14-75B).
■ Macular amyloidosis: pruritic, gray-brown, reticulated macular lesions occurring principally on the upper back the lesions often have a distinctive “ripple”pattern.