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Primary Amyloidosis of the Stomach, Report of a Case Y. Okabayashi 1 1Department of Surgery, Matsusaka Chuo Hospital Koseiren of Mie pp.959-964
Published Date 1982/9/25
DOI https://doi.org/10.11477/mf.1403108808
  • Abstract
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 A 60-year-old woman was admitted to our hospital with upper gastrointestinal bleeding on Jan. 9, 1978. She had episodes of complaints of anorexia and nausea since Sept. '77 without medications.

 Four days before admission, she complained of dull epigastric pain and had tarry stool.

 On the basis of easily bleeding mucosa, an ulcerative lesion at the greater curvature of the antrum and giant folds seen endoscopically and radiologically, the case was interpreted as malignant lymphoma or advanced cancer (Borrmann 3). However, biopsy specimens were histologically negative for malignancy.

 A total gastrectomy was performed because of persisting gastrointestinal bleeding. Macroscopically, the mucosa of the resected stomach was diffusely edematous and swollen with submucosal bleeding, but no dominant ulceration or tumor was seen. Microscopically, homogenous acidophilic depositions were seen among the muscle fibers of the muscularis mucosa and every surrounding submucosal vessels. This material was positive for congo red and crystal violett stain, indicating the presence of the amyloid infiltration.

 Postoperatively, workup for amyloidosis was done. Rectal biopsies were negative for amyloid deposition. Serum immunoelectrophoresis revealed a normal pattern and other laboratory data were within normal range.

 About four months later, she complained of severe abdominal pain and unfortunately died of asphyxiation by the aspiration of vomitus.

 An autopsy was performed. Acute panperitonitis resulting from the perforation of strangulated ileum was recognized. Microscopic examination revealed that amyloid deposition was only seen in the left lung, and not in other organs (kidney, liver, heart, bone, muscle,G-I tract, etc.).


Copyright © 1982, 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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