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Characteristic Duodenal Lesions in Patients with Amyloidosis Shuji Tada 1 , Mitsuo Iida 2 , Naotsugu Ueno 1 1Department of Gastroenterology, 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 , 十二指腸 , アミロイド蛋白 , 鑑別診断 pp.809-817
Published Date 2002/5/25
DOI https://doi.org/10.11477/mf.1403103530
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 Clinicopathologic findings of duodenal lesions were investigated in patients with amyloidosis according to the chemical type of amyloid proteins. Radiographic and endoscopic examination of the duodenum revealed considerable differences between amyloid proteins. In case of amyloid A protein (AA), there was a coarse mucosal pattern with innumerable fine granular elevations, which reflected expansion of the lamina propria by amyloid deposits. Polypoid protrusions and invariable thickening of the folds were evident in cases of light chain protein (AL), correlating with massive amyloid deposits in the muscularis mucosa, submucosa and muscularis propria. In cases of β2-microglobulin (Aβ2M), marked dilatation of the duodenum was seen, indicating extensive amyloid deposits in the muscularis propria. In cases of Atypical transthyretin (ATTR), there was marked delay in transit time because of the significant amount of amyloid deposits in the nerves of the gastrointestinal tract. Characteristic radiographic and endoscopic changes due to the amyloid deposits of each chemical type can be detected easily in the duodenum.

 In addition, to the above comparisons, we demonstrated the morphological differences in the duodenum between amyloidosis and other intestinal diseases such as strogyloidiasis, isosporiasis, immunoproliferative small intestinal disease and intestinal lymphangiectasia.


Copyright © 2002, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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