2020 Volume 19 Issue 3 Pages 174-179
A 60-year-old woman presented with a 1-year history of asymptomatic subcutaneous nodules on the lower extremities. Physical examination revealed multiple hard subcutaneous nodules with a smooth surface distributed on the bilateral lower extremities. Histopathological examination of a skin biopsy specimen from her left lower extremity revealed nodules with eosinophilic amorphous material in the dermis to the subcutaneous tissue. Congo red and direct fast scarlet staining tests revealed the amorphous material was amyloid, and immunohistochemical examination confirmed it to be light-chain (AL) amyloid. Additionally, a transbronchial biopsy specimen from a nodule of the left lung showed amyloid deposition. Further investigation showed involvement of no organ other than skin and the bilateral lungs. She has been stable over two years of follow-up. Systemic AL amyloidosis rarely presents with primary clinical features of multiple subcutaneous nodules of the extremities. Treatments and prognoses differ depending on disease types and organs affected by this condition. Early diagnosis is essential for appropriate treatment. Skin Research, 19 : 174-179, 2020
