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The Part 3 of 3 parts tutorial on Amyloidosis.In this part i have described the morphology of different organs and diagnosis of amyloidosis. Visit http://ilovepathology.com/ for more topics in Pathology! • ***Follow me**** • to view AMyloidosis Part 1 Click here: • AMYLOIDOSIS: Part 1: Definition, Hist... • to view AMyloidosis Part 2 Click here: • AMYLOIDOSIS: PART 2: Pathogenesis C... • Twitter : / vijaypatho • / ilovepathology2 • Facebook: / ilovepathology • AMYLOIDOSIS 3 • Organs Involved in Amyloidosis • Primary Amyloidosis: Heart, GIT, Respiratory tract, peripheral nerves, skin and tongue • Secondary Amyloidosis: Kidney, liver, spleen, lymphnode adrenals and thyroid • Familial Mediterranean fever: Widespread. • Kidney, blood vessels , spleen, respiratory tract and liver • Morphology of Amyloidosis • Macroscopy/ Gross examination • May or may not be visible • If the deposits are too much, then the organ is enlarged, gray, waxy and firm. • Microscopic Examination • Extracellular • Can be adjacent to basement membranes, if the deposits are more, it encroaches on cells and destroy • Can be perivascular or vascular • Amorphous, eosinophilic, glassy/hyaline like • Should be differentiated from collagen, fibrin etc • v1. Congo Red Stain • Ordinary light: Amyloid appears red/pink • Polarizing microscopy: Apple Green Birefringence • Cross beta pleated sheet confirmation is the reason for this special staining property! • Diagnosis of amyloidosis • Despite strong suspicion, the diagnosis of systemic amyloidosis has to be confirmed by tissue diagnosis/ histopathological examination • Abdominal fat pad aspiration /biopsy is the preferred method for diagnosis. • Simplicity, low cost, less complications and good accuracy • Rectal and Gingival biopsy ( previously these were preferred) or labial salivary gland biopsy. • vRectal and Gingival biopsy ( previously these were preferred) or labial salivary gland biopsy. • To know the type of Amyloid: Immunohistochemistry is currently the standard method for amyloid typing in routine practice.
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