Skip to main content

Advertisement

SpringerLink
Log in

Localized amyloidosis of the stomach mimicking a superficial gastric cancer

  • Case Report
  • Published:
Clinical Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

A 73-year-old man was referred to our hospital for further examination of a depressed lesion in the stomach found by cancer screening gastroscopy. A barium upper gastrointestinal series showed an area of irregular mucosa measuring 15 mm on the anterior wall of the gastric body. Esophagogastroduodenoscopy revealed a 15 mm depressed lesion on the anterior wall of the lower gastric body. We suspected an undifferentiated adenocarcinoma from the appearance and took some biopsies. However, histology of the specimens revealed amyloidal deposits in the submucosal layer without malignant findings. Congo red staining was positive for amyloidal protein and green birefringence was observed under polarized light microscopy. Congo red staining with prior potassium permanganate incubation confirmed the light chain (AL) amyloid type. There were no amyloid deposits in the colon or duodenum. Computed tomography of the chest, abdomen, and pelvis showed no remarkable findings. Thus, this case was diagnosed as a localized gastric amyloidosis characterized by AL type amyloid deposition in the mucosal or submucosal layer. As the clinical outcome of gastric AL amyloidosis seems favorable, this case is scheduled for periodic examination to recognize potential disease progression and has been stable for 2 years.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Falk RH, Comenzo RL, Skinner M. Medical progress—the systemic amyloidoses. New Engl J Med. 1997;337:898–909.

    Article  CAS  PubMed  Google Scholar 

  2. Sattianayagam PT, Hawkins PN, Gillmore JD. Systemic amyloidosis and the gastrointestinal tract. Nat Rev Gastroenterol Hepatol. 2009;6:608–17.

    Article  CAS  PubMed  Google Scholar 

  3. Kamata T, Suzuki H, Yoshinaga S, et al. Localized gastric amyloidosis differentiated histologically from scirrhous gastric cancer using endoscopic mucosal resection: a case report. J Med Case Rep. 2012;6:231.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wu D, Lou JY, Chen J, et al. A case report of localized gastric amyloidosis. World J Gastroenterol. 2003;9:2632–4.

    PubMed  PubMed Central  Google Scholar 

  5. Deniz K, Sari I, Torun E, Patiroğlu TE. Localized gastric amyloidosis: a case report. Turk J Gastroenterol. 2006;17:116–9.

    PubMed  Google Scholar 

  6. Chen WC, Raimondo M. Localized gastric amyloidosis mimicking a submucosal tumor-like gastric cancer. Gastrointest Endosc. 2015;82:177.

    Google Scholar 

  7. James DG, Zuckerman GR, Sayuk GS, Wang HL, Prakash C. Clinical recognition of Al type amyloidosis of the luminal gastrointestinal tract. Clin Gastroenterol Hepatol. 2007;5:582–8.

    Article  PubMed  Google Scholar 

  8. Ayabe T, Maekawa I, Ashida T, et al. A case of gastric amyloidosis developing into Bence-Jones type multiple myeloma treated effectively by Cyclo-VAMP chemotherapy. Jpn J Cancer Chemother. 1993;20:2399–403.

    CAS  Google Scholar 

  9. Ikeda K, Murayama H. A case of amyloid tumor of the stomach. Endoscopy. 1978;10:54–8.

    Article  CAS  PubMed  Google Scholar 

  10. Björnsson S, Jóhannsson JH, Sigurjónsson F. Localized primary amyloidosis of the stomach presenting with gastric hemorrhage. Acta Med Scand. 1987;221:115–9.

    Article  PubMed  Google Scholar 

  11. Yanai H, Fuji T, Tada M, et al. Localized amyloidosis of the stomach. Gastrointest Endosc. 1991;37:408–9.

    Article  CAS  PubMed  Google Scholar 

  12. Rotondano G, Salerno R, Cipolletta F, et al. Localized amyloidosis of the stomach: a case report. World J Gastroenterol. 2007;13:1877–8.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Jin S-Z, Qu B, Han MZ, et al. Endoscopic submucosal dissection combined with orally administered dimethyl sulfoxide for primary gastric localized amyloidosis. Clin Res Hepatol Gastroenterol. 2014;38:E79–83.

    Article  PubMed  Google Scholar 

  14. Yamaguchi T, Inoue T, Nishida T, et al. Localized gastric amyloidosis mimicking a submucosal tumor-like gastric cancer. Gastrointest Endosc. 2015;82:175–7.

    Article  PubMed  Google Scholar 

  15. Kawaura Y, Kanehira E, Ohta Y, Nakano I. Predicting histologic findings from endoscopic appearance of early gastric cancer. J Clin Gastroenterol. 1991;13:517–20.

    Article  CAS  PubMed  Google Scholar 

  16. Urakami Y, Sano T, Begum S, Endo H, Kawamata H, Oki Y. Endoscopic characteristics of low-grade gastric mucosa-associated lymphoid tissue lymphoma after eradication of Helicobacter pylori. J Gastroenterol Hepatol. 2000;15:1113–9.

    Article  CAS  PubMed  Google Scholar 

  17. Yamada M, Hatakeyama S, Tsukagoshi H. Gastrointestinal amyloid deposition in AL (primary or myeloma-associated) and AA (secondary) amyloidosis: diagnostic value of gastric biopsy. Hum Pathol. 1985;16:1206–11.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan

    Miwako Kagawa, Yasuteru Fujino, Naoki Muguruma, Noriaki Murayama, Koichi Okamoto, Shinji Kitamura, Tetsuo Kimura, Kazuhiro Kishi, Hiroshi Miyamoto & Tetsuji Takayama

  2. Department of Pathology and Laboratory Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan

    Hisanori Uehara

Authors
  1. Miwako Kagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yasuteru Fujino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Naoki Muguruma
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Noriaki Murayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Koichi Okamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shinji Kitamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tetsuo Kimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kazuhiro Kishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hiroshi Miyamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hisanori Uehara
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Tetsuji Takayama
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tetsuji Takayama.

Ethics declarations

Conflict of Interest:

Authors declare that they have no conflict of interest.

Human Rights:

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed Consent:

Informed consent was obtained from the patient for being included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kagawa, M., Fujino, Y., Muguruma, N. et al. Localized amyloidosis of the stomach mimicking a superficial gastric cancer. Clin J Gastroenterol 9, 109–113 (2016). https://doi.org/10.1007/s12328-016-0651-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12328-016-0651-x

Keywords

Search

Navigation