Clinicopathological conference: amyloidosis and light chain myeloma in a 68-year-old man

Abstract

A 68-year-old man presented with chest pain, weight loss, sore tongue, thigh claudication and bilateral carpal tunnel syndrome. Systemic amyloidosis and lambda light chain myeloma were diagnosed. Amyloid deposition was found in tongue, synovium of carpal tunnel, kidneys, lungs and subcutaneous fat. Non-amyloid needle-shaped crystals with periodic structure were found in renal tubules. While it was evident that our patient had myeloma-associated amyloidosis, the aetiological significance of silicosis, tuberculosis and hepatitis B in this patient were discussed. A total of five patients with amyloidosis has been diagnosed in this hospital in the past two years, suggesting that the condition may not be rare among Chinese. Literature on the epidemiology of amyloidosis among Chinese, as well as the diverse manifestations of amyloidosis were reviewed. A heightened awareness among doctors is required to diagnose this multi-system disorder early.