Characteristic Gastrointestinal Tract Lesions in Patients with Primary and Secondary Amyloidosis Shuji Tada 1 , Mitsuo Iida 2 1Department of Gastroentelogy, Saiseikai Kumamoto Hospital 2Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University Keyword: アミロイドーシス , 原発性 , 続発性 , アミロイド蛋白 pp.611-618
Published Date 2003/4/24
DOI https://doi.org/10.11477/mf.1403100921
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 Clinicopathologic findings of gastrointestinal tract lesions were investigated, according to the chemical type of amyloid proteins, in patients with primary and secondary amyloidosis. Radiographic and endoscopic examination of the gastrointestinal tract revealed considerable differences between amyloid proteins. In cases of primary amyloidosis, consisting of light chain protein (AL), there were polypoid protrusions and invariable thickening of the folds, which reflected massive amyloid deposits in the muscularis mucosa, submucosa and muscularis propria. A coarse mucosal pattern with innumerable fine granular elevations was evident in cases of secondary amyloidosis, consisting of amyloid A protein (AA), and correlating with expansion of the lamina propria by amyloid deposits. Clinically, a frequent occurence of diarrhea, malabsorption, and gastrointestinal tract bleeding was present in the AA cases, whereas chronic intestinal pseudo-obstruction and mechanical obstruction were evident in the AL cases. Clinicopathologic differences between the AL and the AA do exist in gastrointestinal amyloidosis, and radiographic and endoscopic appearance indicates the specific accumulation pattern of each type of amyloid protein.

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