Unusual Amyloid Bodies in Human Liver

French, Samuel W.; Schloss, Gerd; Stillman, Alfred E.

doi:10.1093/ajcp/75.3.400

Cited by 25 publications

(5 citation statements)

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“…Livni et al (15) described deposition of similar globular structures in the parenchyma of the liver in two elderly men, each with chronic pulmonary disease. French et al (16) recently reported a single case of hepatic parenchymal globular deposition of amyloid, substantiated by histochemistry and electron microscopy in an elderly man with pyelonephritis and diabetes mellitus.…”

Section: Discussionmentioning

confidence: 87%

Globular hepatic amyloid--an unusual morphologic presentation

1981

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Hepatic amyloid, when identified, is usually located in the sinusoids, portal tracts, and arterioles. We report 14 cases of hepatic amyloidosis where eosinophilic globules having the histochemical and electron microscopic features of classic amyloid were found. The globules were round to oval, 5 to 40 micrometer in diameter, and were found within the space of Disse as well as aggregated within the portal tracts. There were no distinctive clinical or laboratory features distinguishing this type of amyloidosis from classic hepatic amyloidosis. However, there were no cases of multiple myeloma and only one of benign monoclonal gammopathy. All seven patients who were studied at postmortem examination had systemic (nonglobular) amyloidosis. This form of hepatic amyloidosis is probably not an early form of the disease but is an original but rare presentation of hepatic amyloid deposition.

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Section: Discussionmentioning

confidence: 87%

Globular hepatic amyloid--an unusual morphologic presentation

1981

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“…[18][19][20][21] However, the liver is the most common site, with approximately 80 cases reported to date. 22 Kanel et al 10 in their series of 14 cases suggested that this globular form of amyloid was not an early form of reticular or collagenous amyloid deposition but probably represented a distinctive presentation of hepatic amyloidosis. 22 Kanel et al 10 in their series of 14 cases suggested that this globular form of amyloid was not an early form of reticular or collagenous amyloid deposition but probably represented a distinctive presentation of hepatic amyloidosis.…”

Section: Discussionmentioning

confidence: 97%

“…Globular amyloid deposits have been reported in few organs aside from the liver, including the gastrointestinal tract, 12-14 uterine cervix, 15 medullary thyroid carcinoma, 16 pancreatic neuroendocrine tumor, 17 and pituitary adenomas. 4,5,[9][10][11][22][23][24] Globular amyloid deposits within the liver were first described by Livni et al in 1977, 24 but the word "globular amyloid" was first used by French et al in 1980. 4,5,[9][10][11][22][23][24] Globular amyloid deposits within the liver were first described by Livni et al in 1977, 24 but the word "globular amyloid" was first used by French et al in 1980.…”

Section: Discussionmentioning

confidence: 99%

Globular Hepatic Amyloid Is Highly Sensitive and Specific for LECT2 Amyloidosis

Chandan

Shah

Lam-Himlin

et al. 2015

American Journal of Surgical Pathology

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Globular hepatic amyloid (GHA) is rare, and its clinical significance remains unclear. Recently, leukocyte chemotactic factor-associated amyloidosis (ALECT2) has been reported to involve the liver, showing a globular pattern. We reviewed 70 consecutive cases of hepatic amyloidosis to determine the prevalence and morphology of hepatic amyloid subtypes, especially ALECT2 and its association with GHA. Each case was reviewed for amyloid subtype (immunohistochemistry and/or mass spectrometry), its pattern (linear or globular), and distribution (vascular, perisinusoidal, or stromal). In addition, 24 cases of confirmed hepatic ALECT2 on mass spectrometry from our consultation files were also reviewed. LECT2 immunostaining was performed in 49 cases. Of the 70 cases, immunoglobulin light chain (AL) type was most common with 41 cases (59%), followed by transthyretin (ATTR) 15 cases (22%), 3 cases each of fibrinogen A (AFib) (4%), serum amyloid A (AA) (4%), and ALECT2 (4%), 2 cases of apolipoproteins (AApoA1) (3%), and 3 cases (4%) were unclassified. Three of our 70 cases (4%), with ALECT2, and all 24 cases (100%) of mass spectrometry-confirmed hepatic ALECT2 showed only GHA deposits in the hepatic sinusoids and portal tracts. Three (4%) other cases of AL type showed a focal globular pattern admixed with prominent linear amyloid. None of the other amyloid subtypes showed GHA. LECT2 immunostain was positive in all 27 cases (100%) of ALECT2 and negative in the other 22 non-ALECT2 cases (100%) (14 AL, 5 ATTR, 1 AA, 1 AFib, 1 AApoA1). Pure GHA is uncommon (4%) but is highly specific for ALECT2, and LECT2 immunostain is helpful in confirming this amyloid type.

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“…The diagnosis of liver involvement by amyloidosis is often made easy by the histological appearance and by the help of ancillary stains, polarization microscopy, and electron microscopy. Amyloid deposition in the form of globular inclusion-like bodies in the liver, however, is a rare occurrence, with only 24 cases reported to date [1][2][3][4][5][6]. It remains largely an enigma to the general pathologist and may cause diagnostic confusion.…”

Section: Introductionmentioning

confidence: 99%