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[Amyloidosis induced colonic stricture. The first symptom of myeloma multiplex. A case report].
Orv Hetil. 2008 Jun 22; 149(25):1181-5.OH

Abstract

Systemic amyloidosis often involves the gastrointestinal tract and usually presents as ulceration or polypoid lesions. However, annular stricture of the colon due to amyloidosis is very rare. Amyloidosis develops in appr. 10% of multiple myeloma patients with lambda light chain production, it is usually type AL and not a presenting symptom.

CASE REPORT

A 73-year-old female patient appeared at our hospital with anaemia, abdominal pain and hematochezia. Colonoscopy revealed a circular narrowing of the sigmoid colon suggesting malignancy. The patient underwent sigmoid resection and rectosigmoidal anastomosis was prepared to relieve mechanical obstruction. Surprisingly the histological finding from the resected specimen was amyloidosis. Subcutaneous fat tissue biopsy established the diagnosis of systemic AA amyloidosis. Immunoelectrophoresis revealed an elevated gamma-globulin fraction with IgG lambda monoclonal component, as well as a different lambda light chain. Therefore bone marrow biopsy was carried out which confirmed the diagnosis of multiple myeloma.

DISCUSSION

Our case is a rare example of the extraordinary tumor-mimicking colon amyloidosis that led to the diagnosis of multiple myeloma. Beside haematological treatment, strict follow-up of the colon process and reconsideration of surgical therapy or endoscopic stenting is of great importance.

Authors+Show Affiliations

Szegedi Tudományegyetem, Altalános Orvostudományi Kar, I. Belgyógyászati Klinika. annanita3@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

hun

PubMed ID

18547895

Citation

Annaházi, Anita, et al. "[Amyloidosis Induced Colonic Stricture. the First Symptom of Myeloma Multiplex. a Case Report]." Orvosi Hetilap, vol. 149, no. 25, 2008, pp. 1181-5.
Annaházi A, Németh I, Modok S, et al. [Amyloidosis induced colonic stricture. The first symptom of myeloma multiplex. A case report]. Orv Hetil. 2008;149(25):1181-5.
Annaházi, A., Németh, I., Modok, S., Szentpáli, K., Tiszlavicz, L., Wittmann, T., & Czakó, L. (2008). [Amyloidosis induced colonic stricture. The first symptom of myeloma multiplex. A case report]. Orvosi Hetilap, 149(25), 1181-5. https://doi.org/10.1556/OH.2008.28365
Annaházi A, et al. [Amyloidosis Induced Colonic Stricture. the First Symptom of Myeloma Multiplex. a Case Report]. Orv Hetil. 2008 Jun 22;149(25):1181-5. PubMed PMID: 18547895.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Amyloidosis induced colonic stricture. The first symptom of myeloma multiplex. A case report]. AU - Annaházi,Anita, AU - Németh,István, AU - Modok,Szabolcs, AU - Szentpáli,Károly, AU - Tiszlavicz,László, AU - Wittmann,Tibor, AU - Czakó,László, PY - 2008/6/13/pubmed PY - 2008/9/18/medline PY - 2008/6/13/entrez SP - 1181 EP - 5 JF - Orvosi hetilap JO - Orv Hetil VL - 149 IS - 25 N2 - UNLABELLED: Systemic amyloidosis often involves the gastrointestinal tract and usually presents as ulceration or polypoid lesions. However, annular stricture of the colon due to amyloidosis is very rare. Amyloidosis develops in appr. 10% of multiple myeloma patients with lambda light chain production, it is usually type AL and not a presenting symptom. CASE REPORT: A 73-year-old female patient appeared at our hospital with anaemia, abdominal pain and hematochezia. Colonoscopy revealed a circular narrowing of the sigmoid colon suggesting malignancy. The patient underwent sigmoid resection and rectosigmoidal anastomosis was prepared to relieve mechanical obstruction. Surprisingly the histological finding from the resected specimen was amyloidosis. Subcutaneous fat tissue biopsy established the diagnosis of systemic AA amyloidosis. Immunoelectrophoresis revealed an elevated gamma-globulin fraction with IgG lambda monoclonal component, as well as a different lambda light chain. Therefore bone marrow biopsy was carried out which confirmed the diagnosis of multiple myeloma. DISCUSSION: Our case is a rare example of the extraordinary tumor-mimicking colon amyloidosis that led to the diagnosis of multiple myeloma. Beside haematological treatment, strict follow-up of the colon process and reconsideration of surgical therapy or endoscopic stenting is of great importance. SN - 0030-6002 UR - https://www.unboundmedicine.com/medline/citation/18547895/[Amyloidosis_induced_colonic_stricture__The_first_symptom_of_myeloma_multiplex__A_case_report]_ L2 - http://www.akademiai.com/doi/full/10.1556/OH.2008.28365?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -