Head and neck amyloidosis
Journal Title: Otolaryngologia Polska - Year 2008, Vol 62, Issue 5
Abstract
Introduction. Amyloid is a pathological protein which can accumulate in almost every tissue, consequently resulting in illness (amyloidosis). Amyloid has a red color when the slice preparation is stained with Congo red staining and under polarized light exhibits a characteristic apple-green color. Over 26 different proteins, that can form amyloid, have been described. AL, AA and ATTR amyloidosis are the most frequent type of amyloidosis. Head and neck is a rare region for amyloidosis, which can be localized and/or systemic. Early diagnosis and precise classifi cation of the amyloidosis is essential for treatment planning. Various treatment strategies: antinflammatory management, chemotherapy, immunotherapy, surgery, gene therapy, to name just a few, are already readily available or are currently being explored or researched. Material and methods. Three cases are presented here: an elderly women with tongue and neck tumor and two patients with laryngeal tumors. The biopsy of the lingual and laryngeal tumor and ultrasonography in the fi rst case have been performed in the ENT-Department and Ambulance. Results. In the Internal Medicine Department the patient with lingual and neck tumor, due to symptoms such as: swallowing disorders, dysartria, painful joints swelling and carpal syndrome in anamnesis, previously underwent an examination in order to rule out scleroderma. The investigation appeared to be negative. The histopathology investigation of the lingual tumor identified amyloidosis. USG has not revealed any signifi cant findings. The two patients with laryngeal tumor, except for hoarseness, has not manifested other symptoms suggesting general illness. The biopsy established that there was localized amyloidosis. Conclusion. Diagnosis of amyloidosis and its correct classifi cation continue to pose a great challenge. Two factors play a pivotal role in the identifi cation of local or systemic amyloidosis: the local and/or systemic manifestation and Congo red staining as a gold diagnostic standard.
Authors and Affiliations
Małgorzata Leszczyńska, Łukasz Borucki, Mariola Popko
Keywords
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