A case of primary localized amyloidosis in both tonsils

Eriksen, H. E.

doi:10.1017/s0022215100072182

Cited by 12 publications

(3 citation statements)

References 5 publications

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“…Amyloid deposited in lymphatic tissue has been described (rarely) in the tonsil [2,6,7,10,14,26,31], is observed more frequently in lymph nodes and may be present in 6-23% of cases with generalized amyloidosis [8,20,25,33,34,36,38,49]. From previous investigations, it appears that the tonsils and lymph nodes are mainly affected by AL amyloidosis and only occasionally by other forms, such as AA amyloidosis (15 versus two characterized cases) [2,8,20,25,33,34,49].…”

Section: Pathologic Findingsmentioning

confidence: 99%

Plasmacytoma of the tonsil with AL amyloidosis: evidence of post-fibrillogenic proteolysis of the fibril protein

et al. 2000

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We report of a 58-year-old Caucasian man who was referred to the University Hospital with a greatly enlarged left tonsil which showed calcifications on computed-tomography scans. Histopathology revealed a plasmacytoma with secondary AL amyloidosis, ossifications, and multinucleated foreign-body-type giant cells. N-terminal sequencing of amyloid-fibril proteins purified from the formalin-fixed tissue showed the presence of two proteins of different size; these were of lambda-light-chain origin (subgroup V), measured approximately 15.2 kDa and 10.5 kDa, and had identical N-terminal ends (YVLTQPP). When the amyloid deposits were immunolabeled with a polyclonal antibody directed against lambda light chain, they showed two staining patterns: some deposits showed intense immunolabeling while others were not immunoreactive. Immunostaining of amyloid was completely absent after protease pre-treatment. Immunoelectron microscopy with gold-labeled secondary antibodies showed staining that was spatially related to amyloid fibrils and suggested that the antibody probably detected the fibril protein. Therefore, our hypothesis in this case is that the different immunostaining patterns are due to a post-fibrillogenic proteolysis of the fibril protein at the C-terminal end of the light chain, as indicated by the presence of two differently sized lambda-light-chain fragments with identical N-terminal ends.

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Section: Pathologic Findingsmentioning

confidence: 99%

Plasmacytoma of the tonsil with AL amyloidosis: evidence of post-fibrillogenic proteolysis of the fibril protein

et al. 2000

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“…Higher polymeric light chains (tri-or tetramers) were demonstrated as a small peak between intact immunoglobulins and dimeric light chains. The total Four patients had localized amyloidosis limited to the respiratory tract and no Coexisting diseases (3,6,7). Four patients had secondary amyloidosis: three had Table I.…”

Section: Resultsmentioning

confidence: 99%

Free Light Chains of Immunoglobulins in Amyloidosis

Sølling

1979

Journal of Internal Medicine

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Monomeric (M) and dimeric (D) forms of free light chains in serum have been measured by a sensitive radioimmunoassay in eight patients with amyloidosis without monoclonal proteins. Significantly elevated concentrations of D lambda chains were demonstrated in two of four patients with localized amyloidosis. The two patients had a significantly increased D/M ratio of both kappa and lambda chains. One patient with localized amyloidosis and normal concentration of monomeric and dimeric light chains had an abnormal fragment of light chains. A low kappa/lambda ratio was found in patients with localized amyloidosis. Four patients with secondary amyloidosis and renal insufficiency had increased amounts of free light chains. The concentration of light chains and the D/M ratio in this group corresponded to the impairment of renal function.

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“…In 1 case, amyloidosis involved both tonsils. 18 The presenting symptoms of tonsillar amyloidosis are dysphagia, odynophagia, and respiratory discomfort. Diagnosis is usually based on oral examination and histopathologic evaluation of excisional or incisional tissue biopsy specimens.…”

Section: Discussionmentioning

confidence: 99%

Management of Upper Aerodigestive Tract Amyloidosis

Çelenk

Durucu²,

Baysal³

et al. 2013

Ann Otol Rhinol Laryngol

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Surgical resection is the primary treatment for patients with upper aerodigestive tract amyloidosis. Radiation therapy is especially effective in cases of recurrent amyloidosis with submucosal involvement. Pedunculated polypoid lesions may be treated with surgery alone, and in cases of recurrence, irradiation following the surgical removal should be considered. Tonsillectomy is usually sufficient for treating tonsillar amyloidosis.

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A case of primary localized amyloidosis in both tonsils

Cited by 12 publications

References 5 publications

Plasmacytoma of the tonsil with AL amyloidosis: evidence of post-fibrillogenic proteolysis of the fibril protein

Plasmacytoma of the tonsil with AL amyloidosis: evidence of post-fibrillogenic proteolysis of the fibril protein

Free Light Chains of Immunoglobulins in Amyloidosis

Management of Upper Aerodigestive Tract Amyloidosis

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