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2016 ; 468
(5
): 569-77
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Amyloid in biopsies of the gastrointestinal tract-a retrospective observational
study on 542 patients
#MMPMID26915034
Freudenthaler S
; Hegenbart U
; Schönland S
; Behrens HM
; Krüger S
; Röcken C
Virchows Arch
2016[May]; 468
(5
): 569-77
PMID26915034
show ga
In this retrospective observational study, we investigated the histopathological
and demographic characteristics of amyloid in gastrointestinal biopsies. From the
Amyloid Registry Kiel, we retrieved all cases with amyloid in biopsies of the
stomach, duodenum, small intestine, large intestine, and rectum submitted for
tertiary referral between January 2003 and April 2013. Amyloid was identified by
Congo red staining in combination with polarization microscopy and classified by
immunohistochemistry. The TTR-genotype was assessed in 56 patients. Amyloid type
was correlated with demographic patient characteristics. Six hundred sixty-three
biopsies from 542 patients were retrieved. Amyloid was found in each biopsy as
vascular and/or interstitial amyloid deposits. Biopsies were obtained from the
colon [254 biopsies (38.3 %)], stomach, [153 (23.1 %)], rectum [112 (16.9 %)],
duodenum [105 (15.8 %)], and jejunum/ileum [39 (5.9 %)]. AL? amyloid was found in
286 (52.8 %), ATTR in 88 (16.2 %), AL? in 74 (13.7 %), AA in 58 (10.7 %), and
ApoAI amyloid in 4 (0.7 %) patients. The remaining 21 cases were ALys amyloid in
4 (0.7 %), AL n.o.s. in 14 (2.6 %), and mixed type amyloidosis in 3 (0.6 %). The
amyloid of 11 (2.0 %) cases remained unclassified. The median age of the patients
was 68 years. Men [332 (61.7 %)] were significantly more prevalent than women
[206 (38.3 %); p < 0.001]. TTR mutations were found in 24 % of the patients with
ATTR amyloidosis. The median age, the histoanatomical distribution (proximal to
distal; mucosal to submucosal), and the deposition pattern
(vascular/interstitial) varied between different amyloid types. Amyloid in
gastrointestinal biopsies mainly affects male elderly patients and shows
amyloid-type-specific demographic patient characteristics.