Imaging of Focal Amyloid Depositions in the Head, Neck, and Spine: Amyloidoma

Parmar, Hemant; Rath, T; Castillo, Maurício; Gandhi, Dheeraj

doi:10.3174/ajnr.a1977

Cited by 49 publications

(40 citation statements)

References 22 publications

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“…The lesions are described as well-defined homogeneous soft-tissue masses, with no or only a slight degree of contrast enhancement (Godbersen GS, 1992). Occasionally, areas of localized calcification within the mass are present (Hegarty JL, 1993) (Parmar H, 2010). Although the amyloidosis does not generally induce osteolysis, one case of nasopharyngeal amyloidosis with sinus extension and bone destruction suggestive of malignancy has been reported (Zhuang YL, 2005).…”

Section: Radiologymentioning

confidence: 99%

Localized ENT Amyloidosis – Literature Overview

Hammami¹,

Mnejja²,

Sellami³

et al. 2011

Amyloidosis - An Insight to Disease of Systems and Novel Therapies

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Section: Radiologymentioning

confidence: 99%

Localized ENT Amyloidosis – Literature Overview

Hammami¹,

Mnejja²,

Sellami³

et al. 2011

Amyloidosis - An Insight to Disease of Systems and Novel Therapies

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“…Amyloid may occur anywhere in the neck, although laryngeal involvement is most common [5] . CT of the head and neck reveals diffuse or focal organ infiltration, with or without calcification [5] .…”

Section: Head and Neckmentioning

confidence: 99%

“…Involvement of cervical lymph nodes is rare, even in systemic amyloidosis, with nodes often appearing with intermediate intensity on T1-weighted images, and decreased intensity on T2-weighted images [8] . Extranodal amyloid in the head and neck tends to maintain an iso-to hypointense appearance on T1-weighted imaging, and may be hypo, iso, or minimally hyperintense on T2-weighted imaging [5] . Fig.…”

Section: Head and Neckmentioning

confidence: 99%

“…Intracerebral amyloid (also known as amyloid angiopathy) is not usually associated with systemic amyloidosis, and is characterized by protein deposition in the media and adventitia of small to medium sized cortical and leptomeningeal vessels, leading to vessel damage, hemorrhage, and infarction [5][6][7] . Chronic hypoperfusion leads to leukoencephalopathy and atrophy, manifesting as periventricular hypodensity on computed tomography (CT), or hyperintensity on T2-weighted images on magnetic resonance imaging (MRI) [6] .…”

Section: Brainmentioning

confidence: 99%

“…CT of the head and neck reveals diffuse or focal organ infiltration, with or without calcification [5] . Involvement of cervical lymph nodes is rare, even in systemic amyloidosis, with nodes often appearing with intermediate intensity on T1-weighted images, and decreased intensity on T2-weighted images [8] .…”

Section: Head and Neckmentioning

confidence: 99%

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Multimodality imaging in amyloidosis

Howard¹,

Jagannathan²,

Krajewski³

et al. 2012

Cancer Imaging

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Amyloidosis comprises a rare spectrum of protein deposition diseases that diffusely or focally affect any organ. Amyloids variable clinical presentation and nonspecific disease course often cause it to evade early diagnosis. This pictorial essay aims to familiarize radiologists with the pathophysiology of amyloidosis, to describe the basic classifications of amyloidosis, and to use multimodality imaging to illustrate its varied appearance throughout the body. This review highlights the diagnostic challenge of interpreting radiographic studies in patients with hematologic malignancies and concurrent amyloidosis. Radiologists should consider amyloid in chronically ill patients or patients with hematologic malignancies who have unusual/unexpected imaging findings.

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Fine‐needle aspiration of amyloidoma: A critical analysis

Ramani,

Krishnan

2024

Cancer Cytopathology

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BackgroundAmyloid, presenting as a mass, is termed amyloidoma. Among the reported cases, fine‐needle aspiration (FNA) of amyloid is often misinterpreted as acellular nondiagnostic material.MethodsA computer search of all FNAs was performed and cases diagnosed as amyloidoma were identified.ResultsAmong 11,956 cases and 20,634 FNAs, there were six cases and 12 FNAs of amyloidoma. One case with mucin/myxoid matrix was misinterpreted as amyloid, which on our review was Congo red negative. All five other cases of amyloidoma were adequate for evaluation. The smears showed most of the aspirated contents in the middle of the slide and it did not spread when smeared. The amyloid was present as large chunks of waxy, smooth, orangophilic/cyanophilic fragments on Papanicolaou stain and as basophilic fragments on Diff‐Quik stain in a clean background. In cases with lymphoma/myeloma, there were admixed lymphocytes and/or plasma cells. Unlike fibrous tissue, amyloid aspirates well and provides adequate material for interpretation. The clean background distinguishes it from mucin/myxoid matrix. Congo red stain was positive with apple green birefringence in all five cases. Further subtyping by mass spectrometry showed AL (κ) type in three patients and AIns (insulin) type in one patient. In one patient with lymphoma, the subtyping was not done.ConclusionFNA of amyloidoma is rare (0.04%), but an optimal method for diagnosis and subtyping, avoiding unwanted surgical interventions. Although mistaken for fibrous tissue, which aspirates poorly, abundant acellular orangophilic/cyanophilic material on FNA should raise a suspicion for amyloid. Unlike mucin/myxoid matrix, amyloid does not smear the background.

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Imaging of Focal Amyloid Depositions in the Head, Neck, and Spine: Amyloidoma

Cited by 49 publications

References 22 publications

Localized ENT Amyloidosis – Literature Overview

Localized ENT Amyloidosis – Literature Overview

Multimodality imaging in amyloidosis

Fine‐needle aspiration of amyloidoma: A critical analysis

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