Primary gastric amyloidosis : Clinical significance of observation using narrow band imaging

Abstract

A 68-year-old woman was diagnosed as having rare primary AL amyloidosis localized in a small IIc-like gastric ulcer at the posterior wall of the antrum. The remarkable infiltration of plasma cells was found ; the lambda positive cells were dominant than the kappa positive cells. Six months after the diagnosis, the IIc-like legion changed to the shallow and broad ulcer, resulting in no definite changes during the several-year observation. Narrow Band Imaging (NBI) identified the margin of these amyloidosis related ulcer more distinctively than normal lights with diffuse whitish appearance. In the similar case with the shallow ulcer induced by microcirculation disturbance with amyloid deposit, NBI was also useful to distinguish the margin of amyloid deposit from non-deposit legion. To establish the clinical significance, the accumulation of data based on pathological analysis is thus called for.