An abdominal wall mass of exogenous insulin amyloidosis in setting of metastatic sarcoma

Carll, Timothy; Antic, Tatjana

doi:10.1111/cup.13613

Cited by 5 publications

(7 citation statements)

References 7 publications

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“…Eighteen (81.8%) of 22 studies performed HE staining and reported “foreign body giant cells,” “eosinophilic,” “inflammation,” “amorphous,” and “keratosis” as observations 17–33 . Twenty (90.9%) of 22 studies performed Congo red staining and reported green birefringence when viewed with polarized light, consistent with amyloid deposits 3,9,17–21,24–36 .…”

Section: Resultsmentioning

confidence: 99%

“…Eighteen (81.8%) of 22 studies performed HE staining and reported "foreign body giant cells," "eosinophilic," "inflammation," "amorphous," and "keratosis" as observations. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Twenty (90.9%) of 22 studies performed Congo red staining and reported green birefringence when viewed with polarized light, consistent with amyloid deposits. 3,9,[17][18][19][20][21][24][25][26][27][28][29][30][31][32][33][34][35][36] Fifteen (68.1%) of 22 studies performed immunohistochemical (IHC) staining for insulin and reported that LIDA was positive for insulin.…”

Section: Outcome Parameters With Lida In This Scoping Reviewmentioning

confidence: 99%

“…[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Twenty (90.9%) of 22 studies performed Congo red staining and reported green birefringence when viewed with polarized light, consistent with amyloid deposits. 3,9,[17][18][19][20][21][24][25][26][27][28][29][30][31][32][33][34][35][36] Fifteen (68.1%) of 22 studies performed immunohistochemical (IHC) staining for insulin and reported that LIDA was positive for insulin. 3,9,17,[20][21][22][23][24][25][26]28,30,32,…”

Section: Outcome Parameters With Lida In This Scoping Reviewmentioning

confidence: 99%

“…The results of this scoping review also showed that histological evaluation is the gold standard for a definitive diagnosis. Only anti-insulin antibodypositive result 3,9,17,[20][21][22][23][24][25][26]28,30,32,33,35 or Congo red staining 3,9,[17][18][19][20][21][24][25][26][27][28][29][30][31][32][33][34][35][36] can confirm LIDA. Interestingly, noninvasive imaging devices, such as MRI and US, have recently been reported as assessment tools for LH and LIDA.…”

Section: Characteristics Of Lh and Lida In Pathophysiologymentioning

confidence: 99%

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Differences in clinicopathological characteristics between lipohypertrophy and localized insulin‐derived amyloidosis: A scoping review

Mukai,

Tanno,

Sugama

et al. 2023

Chronic Diseases and Translational Medicine

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Insulin is used as a therapeutic agent in patients with diabetes, and cutaneous lipohypertrophy (LH) and localized insulin‐derived amyloidosis (LIDA) are well‐known adverse effects associated with insulin injections. The clinical implications, management, assessment methods, and pathological differentiation of LH and LIDA have been recently updated. This review was to update our knowledge of the pathological differentiation, effects of insulin absorption, hypoglycemic events, and recent assessment methods for LH and LIDA. A scoping review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses extension for Scoping Reviews guidelines. Original studies and case reports in English were also included. PubMed and Scopus databases were searched for keywords to identify papers published up to January 2022. A total of 113 studies were identified through a database search, and 31 were eligible for inclusion in this scoping review. In the 31 studies included in this review, patients with type 2 diabetes had high frequencies of LH and LIDA. LH outcome parameters were assessed using pathological findings and imaging. LIDA is mainly determined by pathological methods, such as hematoxylin and eosin and Congo red staining. Several in vitro and in vivo LIDA models of LIDA have been developed. These results suggest that pathological analysis is required to identify LH and LIDA. It is important to consider LIDA, as it likely influences insulin adsorption and glycemic control. Although several studies have evaluated the LIDA process, little is known about the mechanisms underlying the development of adverse effects associated with insulin injections.

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Section: Resultsmentioning

confidence: 99%

Section: Outcome Parameters With Lida In This Scoping Reviewmentioning

confidence: 99%

Section: Outcome Parameters With Lida In This Scoping Reviewmentioning

confidence: 99%

Section: Characteristics Of Lh and Lida In Pathophysiologymentioning

confidence: 99%

See 2 more Smart Citations

Differences in clinicopathological characteristics between lipohypertrophy and localized insulin‐derived amyloidosis: A scoping review

Mukai,

Tanno,

Sugama

et al. 2023

Chronic Diseases and Translational Medicine

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“…Since AIns was first reported in 1983, 1 over 25 cases have been noted in the literature. 2 The classic clinical presentation is a firm, asymptomatic plaque or subcutaneous nodule 3 at a frequent injection site. Histopathologic examination classically demonstrates homogeneous eosinophilic material and apple-green birefringence with Congo red staining.…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Insulin-Derived Amyloidosis With Acanthosis Nigricans-Like Changes

Godse

Rauck

Woods

et al. 2022

The American Journal of Dermatopathology

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:Insulin-derived amyloidosis (AIns) is a rare iatrogenic subtype of cutaneous amyloidosis occurring at frequent insulin injection sites. Here, we describe 2 cases of AIns accompanied by acanthosis nigricans (AN)-like changes, a rare finding which has been reported fewer than 5 times in the literature. We also report the first case of an AIns nodule being misdiagnosed as a keloid. Both of our patients presented with asymptomatic, hyperkeratotic, pigmented plaques at frequent insulin injection sites, and histopathologic examination showed (1) nodular aggregates of amyloid demonstrating apple-green birefringence with Congo red staining and (2) AN-like features, such as epidermal papillomatosis, hyperkeratosis, and hyperpigmentation. Accurate diagnosis of AIns is crucial, because repeated insulin injection into a nodule can impair glycemic control. However, misdiagnosis is common, as observed with our second patient, whose AIns nodule was misdiagnosed by an outside provider as a keloid, perhaps because of the presence of AN-like features. Our case report adds to the limited but growing body of literature on AIns and significantly increases the number of reported cases of AIns with AN-like features, an even rarer phenomenon.

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