AN ADULT CASE OF STOMACH AMYLOIDOSIS DETECTED BY MAGNIFYING ENDOSCOPY

Abstract

An 85-year-old man presented to a nearby medical clinic following palpitation and tarry stools. On examination, anemia was detected. To further investigate the cause of these symptoms, he was referred to our hospital. Upper gastrointestinal endoscopy revealed elevated lesions throughout the stomach, and the mucous membrane was rough and hemorrhagic. Under magnifying endoscopy, the lesions demonstrated the absence of a mucosal microsurface pattern. However, a wide and meandering microvascular pattern could be seen along the faint margins of the lesions. Histopathological analysis of a tissue biopsy specimen indicated amyloidosis. AL amyloidosis was suspected at first ; however, a specific staining procedure subsequently revealed that the patient had senile systemic amyloidosis (SSA) caused by transthyretin deposition.