Current insight in the localized insulin-derived amyloidosis (LIDA): clinico-pathological characteristics and differential diagnosis

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

“…Exogenous AIns radiologically appears dense and without increased vascularity or necrosis. 3 microglobulin, as seen in patients on hemodialysis. In this case, the presence of metastatic disease as well as the unexpected presence of the amyloid deposit raised concern for involvement by sarcoma.…”

“…Exogenous AIns radiologically appears dense and without increased vascularity or necrosis . It microscopically shows thick eosinophilic amyloid fibrils which strongly and uniformly stain with Congo red, and sparse lymphoplasmacytic infiltrate with occasional foreign body giant cell reactions.…”

“…AIns often presents as a firm, slow-growing and painless cutaneous or subcutaneous nodule at the site of repeated insulin administration as seen in our patient, occasionally with overlying skin changes such as acanthosis nigricans. 3 Some cases have been reported with calcification, 4 or with 30 to 40 μm spherical bodies (so-called insulin amyloid bodies). 5 As the lesion is painless, patients may prefer this site for insulin injection.…”

Atypical presentation of localized insulin‐derived amyloidosis as protruding brownish skin tumours

“…The common clinical presentation of LIDA is a firm, painless, subcutaneous nodule of about 20–50 mm (extreme range 10–120 mm) at the injection site; commonly the abdomen but also frequently in the arm or thigh . It was reported that in patients with LIDA, there was an equal distribution of Type 1 and Type 2 diabetes . LIDA predominantly affects male patients, with a sex ratio of about 2 : 1 .…”

“…Ansari et al . reported that the interval between the start of insulin injection and the diagnosis of LIDA was about 11–47 years in Type 1 diabetes and about 4–26 years in Type 2.…”