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Head and neck amyloidosis: clinicopathological features and immunohistochemical analysis of 14 cases.
J Oral Pathol Med. 2012 Feb; 41(2):178-85.JO

Abstract

BACKGROUND

Amyloidosis is associated with or caused by amyloid deposition. These fibrillar proteins may be deposited extracellularly causing tissue damage or impairment.

OBJECTIVES

The aim of the study was to retrospectively review pathology archives in two oral diagnostic centers for cases fulfilling criteria of amyloidosis and to differentiate AA and AL types of amyloidosis.

METHODS

The clinicopathological features, alkaline Congo red staining, with and without pretreatment with potassium permanganate, and immunohistochemical (IHC) staining with anti-AA, anti-kappa (κ), and anti-lambda (λ) light chain antibodies were carried out and analyzed.

RESULTS

The search identified 14 cases. Ten patients were women and four were men, with a mean age of 58 years. Eleven patients had systemic involvement by amyloidosis (associated either with multiple myeloma or plasma cell dyscrasia/monoclonal gammopathies), while three presented the localized type, one of them associated with plasmacytoma. All cases showed positivity for κ or λ light chains (AL-amyloid) and presented resistance to the potassium permanganate pretreatment.

CONCLUSIONS

Our results show that the head and neck region is preferentially affected by systemic AL-amyloidosis, usually associated with plasma cell dyscrasia. Interestingly, two cases affected by inflammatory rheumatic diseases presented AL-amyloid deposition. Moreover, even after pretreatment with potassium permanganate, which was helpful in highlighting the presence of AL-amyloid, in agreement with the IHC findings, clinical classifications should be carefully made in systemic amyloidosis.

Authors+Show Affiliations

Department of Oral Diagnosis - Oral Semiology and Oral Pathology Sections, Piracicaba Dental School - State University of Campinas, Piracicaba, Sao Paulo, Brazil. adrielefg@yahoo.com.brNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21883489

Citation

Gouvêa, Adriele Ferreira, et al. "Head and Neck Amyloidosis: Clinicopathological Features and Immunohistochemical Analysis of 14 Cases." Journal of Oral Pathology & Medicine : Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, vol. 41, no. 2, 2012, pp. 178-85.
Gouvêa AF, Ribeiro AC, León JE, et al. Head and neck amyloidosis: clinicopathological features and immunohistochemical analysis of 14 cases. J Oral Pathol Med. 2012;41(2):178-85.
Gouvêa, A. F., Ribeiro, A. C., León, J. E., Carlos, R., de Almeida, O. P., & Lopes, M. A. (2012). Head and neck amyloidosis: clinicopathological features and immunohistochemical analysis of 14 cases. Journal of Oral Pathology & Medicine : Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 41(2), 178-85. https://doi.org/10.1111/j.1600-0714.2011.01073.x
Gouvêa AF, et al. Head and Neck Amyloidosis: Clinicopathological Features and Immunohistochemical Analysis of 14 Cases. J Oral Pathol Med. 2012;41(2):178-85. PubMed PMID: 21883489.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Head and neck amyloidosis: clinicopathological features and immunohistochemical analysis of 14 cases. AU - Gouvêa,Adriele Ferreira, AU - Ribeiro,Ana Carolina Prado, AU - León,Jorge Esquiche, AU - Carlos,Román, AU - de Almeida,Oslei Paes, AU - Lopes,Márcio Ajudarte, Y1 - 2011/08/29/ PY - 2011/9/3/entrez PY - 2011/9/3/pubmed PY - 2012/7/21/medline SP - 178 EP - 85 JF - Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology JO - J. Oral Pathol. Med. VL - 41 IS - 2 N2 - BACKGROUND: Amyloidosis is associated with or caused by amyloid deposition. These fibrillar proteins may be deposited extracellularly causing tissue damage or impairment. OBJECTIVES: The aim of the study was to retrospectively review pathology archives in two oral diagnostic centers for cases fulfilling criteria of amyloidosis and to differentiate AA and AL types of amyloidosis. METHODS: The clinicopathological features, alkaline Congo red staining, with and without pretreatment with potassium permanganate, and immunohistochemical (IHC) staining with anti-AA, anti-kappa (κ), and anti-lambda (λ) light chain antibodies were carried out and analyzed. RESULTS: The search identified 14 cases. Ten patients were women and four were men, with a mean age of 58 years. Eleven patients had systemic involvement by amyloidosis (associated either with multiple myeloma or plasma cell dyscrasia/monoclonal gammopathies), while three presented the localized type, one of them associated with plasmacytoma. All cases showed positivity for κ or λ light chains (AL-amyloid) and presented resistance to the potassium permanganate pretreatment. CONCLUSIONS: Our results show that the head and neck region is preferentially affected by systemic AL-amyloidosis, usually associated with plasma cell dyscrasia. Interestingly, two cases affected by inflammatory rheumatic diseases presented AL-amyloid deposition. Moreover, even after pretreatment with potassium permanganate, which was helpful in highlighting the presence of AL-amyloid, in agreement with the IHC findings, clinical classifications should be carefully made in systemic amyloidosis. SN - 1600-0714 UR - https://www.unboundmedicine.com/medline/citation/21883489/Head_and_neck_amyloidosis:_clinicopathological_features_and_immunohistochemical_analysis_of_14_cases_ L2 - https://doi.org/10.1111/j.1600-0714.2011.01073.x DB - PRIME DP - Unbound Medicine ER -