A CASE OF PRIMARY SYSTEMIC AMYLOIDOSIS ASSOCIATED WITH EARLY GASTRIC CARCINOMA (IIc) BOTH DETECTED BY GASTRIC BIOPSY

Abstract

A 57-year-old male visited the university hospital with complaints of anorexia and emaciation on January 1978. His complaints started at 1970 and he lost 20 Kgm during the last 8 years. Urinalysis revealed proteinuria, approximately 3 .5 gm to 6.5 gm per day, but no hematuria nor abnormal immunophoretic protein. Upper GI series showed ulcer scar on the gastric angulus. By endoscopy, besides the ulcer scar on the angulus, small erosive changewhich was highly suggestive of IIc type early carcinoma was found on the anterior aspect of the gastric antrum. Tubular adenocarcinoma was confirmed by histological examination of the biopsy specimen from the erosion and moreover a specimen from the lesser curve of the gastric body, where the mucosa was endoscopically atrophic, revealed amyloid deposit in the tunica propria. Gastrectomy was performed for the gastric carcinoma and a kidney biopsy at the surgery decided the diagnosis of systemic amyloidosis. This is the first case of primary amyloidosis with early gastric carcinoma in literatures and the valus of the upper GI tract biopsy to the diagnosis of amyloidosis was emphasised.