INTRODUCTION: Kidney involvement is a major cause of mortality in systemic amyloidosis. Glomerulus is the most common site of deposition in renal amyloidosis, and nephrotic syndrome is the most common presentation. Distinction between AA and AL is done using immunofluorescence (IF) and immunohistochemistry (IHC). Renal biopsy helps in diagnosis and also predicting the clinical course by applying scoring and grading to the biopsy findings.
MATERIALS AND METHODS: The study includes all cases of biopsy-proven renal amyloidosis from January 2008 to May 2017. Light microscopic analysis; Congo red with polarization; IF; IHC for Amyloid A, kappa, and lambda; and bone marrow evaluation were done. Classification of glomerular amyloid deposition and scoring and grading are done as per the guidelines of Sen S et al.
RESULTS: There are 40 cases of biopsy-proven renal amyloidosis with 12 primary and 23 secondary cases. Mean age at presentation was 42.5 years. Edema was the most common presenting feature. Secondary amyloidosis cases were predominant. Tuberculosis was the most common secondary cause. Multiple myeloma was detected in four primary cases. Grading of renal biopsy features showed a good correlation with the class of glomerular involvement.
CONCLUSION: Clinical history, IF, and IHC are essential in amyloid typing. Grading helps provide a subtle guide regarding the severity of disease in the background of a wide range of morphological features and biochemical values. Typing of amyloid is also essential for choosing the appropriate treatment.
CASE REPORTmolecular studies aid in correct categorization of this new entity. Here, in this article, we present a case of MASC presenting as a painful mass in the parotid gland in a 55-year-old man. In this article, we emphasized on the histological, IHC and molecular studies that characterize this tumor and help to differentiate from its histologic mimics.
ABSTRACTMammary analogue secretory carcinoma is a recently described salivary gland tumor that shares morphologic and genetic characteristics with secretory carcinoma of the breast. Due to its complex and heter\ogeneous presentation, most of these tumors were previously labeled histologically as acinic cell carcinoma, mucoepidermoid carcinoma or adenocarcinoma not otherwise specified. Here we present a case of MASC of the parotid gland in a 55-year-old man and discuss the histological, IHC and molecular features that will facilitate its diagnosis and differentiation from its histologic mimics.
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