Insulin-derived amyloidosis: The insulin ball, amyloidoma

Samlaska, Curt P.; Reber, Sara; Murry, Todd

doi:10.1016/j.jdcr.2020.02.011

Cited by 34 publications

(38 citation statements)

References 13 publications

(30 reference statements)

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“…The inclusion cyst can also be excluded by the use of techniques to demonstrate amyloid 6,10 . Patients who are having human immunodeficiency virus infection and under treatment with Enfuvirtide have also been reported to have induced amyloid deposits at injection sites 8 . However, our patient had no history of injectable enfuvirtide.…”

Section: Discussionmentioning

confidence: 77%

“…Earlier it was thought that insulin of animal source may be the cause for insulin‐induced amyloidomas, however, recombinant human insulin and its analog can also be the causes. These mass of subcutaneous deposits of amyloid have also been termed as “amyloidoma” and “insulin ball.” 8 …”

Section: Discussionmentioning

confidence: 99%

“…Educating patients to use alternative injection sites is crucial for the prevention of localized amyloidosis. Injection sites can be regularly examined for inflammation, infection, or mass formation 6,8 . Treatment of insulin‐induced amyloidoma involves surgical excision of amyloidoma or avoiding of injections at sites.…”

Section: Discussionmentioning

confidence: 99%

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Insulin‐induced amyloidoma—A cytological catch

Santosh

Balakrishna

Gupta³

2020

Diagnostic Cytopathology

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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Insulin‐induced amyloidoma—A cytological catch

Santosh

Balakrishna

Gupta³

2020

Diagnostic Cytopathology

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“…Systemic amyloidosis is denominated by diverse categories of amyloid accumulation a) Amyloid associated (AA) amyloidosis is frequently discerned and exhibits precursor serum amyloid An incriminating the spleen, hepatic and renal parenchyma. Diverse rheumatologic disorders (rheumatoid arthritis, ankylosing spondylitis, juvenile idiopathic arthritis), autoimmune disorders (psoriasis, psoriatic arthritis) or haematological malignancies (Hodgkin's and non Hodgkin's lymphoma, multiple myeloma) are associated with systemic amyloidosis [3,4].…”

Section: Disease Pathogenesismentioning

confidence: 99%

“…Previously treated mycobacterial infection or pulmonary tuberculosis and chronic in lammation arising due to repetitive respiratory tract infections may incur AA amyloidosis [3]. [3,4]. Amyloidosis can also occur with deposition of transthyretin or beta-2 microglobulin thereby articulating transthyretin amyloidosis (ATTR) or beta-2 microglobulin amyloidosis (Abeta2M) or associated varieties of systemic amyloidosis [3,4].…”

Section: Disease Pathogenesismentioning

confidence: 99%

The coral crunch: Amyloidoma

Bajaj¹

2021

Ann Dermatol Res

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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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Insulin-derived amyloidosis: The insulin ball, amyloidoma

Cited by 34 publications

References 13 publications

Insulin‐induced amyloidoma—A cytological catch

Insulin‐induced amyloidoma—A cytological catch

The coral crunch: Amyloidoma

Fine‐needle aspiration of amyloidoma: A critical analysis

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