A Case of Abdominal Aortic Retroperitoneal and Mesenteric Amyloid Light Chain Amyloidoma

We report the case of a Japanese woman with amyloid light chain (AL) amyloidoma in the abdominal aortic retroperitoneum and mesentery. Irregular soft tissue mass lesions with calcification in the abdominal aortic retroperitoneum and mesentery were initially detected by computed tomography at another...

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Main Authors: Kazuhiro Yokota, Dai Kishida, Hidekazu Kayano, Masahide Yazaki, Yuki Shimada, Yuji Akiyama, Toshihide Mimura
Format: Article
Language:English
Published: Hindawi Limited 2016-01-01
Series:Case Reports in Rheumatology
Online Access:http://dx.doi.org/10.1155/2016/4146030
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spelling doaj-c0e747e5c0a44b5689545de0beba4f9d2020-11-25T00:21:41ZengHindawi LimitedCase Reports in Rheumatology2090-68892090-68972016-01-01201610.1155/2016/41460304146030A Case of Abdominal Aortic Retroperitoneal and Mesenteric Amyloid Light Chain AmyloidomaKazuhiro Yokota0Dai Kishida1Hidekazu Kayano2Masahide Yazaki3Yuki Shimada4Yuji Akiyama5Toshihide Mimura6Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Saitama, JapanDepartment of Internal Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Nagano, JapanDepartment of Pathology, Saitama Medical University, Saitama, JapanDepartment of Internal Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Nagano, JapanDepartment of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Saitama, JapanDepartment of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Saitama, JapanDepartment of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Saitama, JapanWe report the case of a Japanese woman with amyloid light chain (AL) amyloidoma in the abdominal aortic retroperitoneum and mesentery. Irregular soft tissue mass lesions with calcification in the abdominal aortic retroperitoneum and mesentery were initially detected by computed tomography at another hospital. The lesions gradually compressed the duodenum, causing symptoms of bowel obstruction. The patient was clinically diagnosed with retroperitoneal fibrosis, and prednisolone was administered at a dose of 40 mg/day. However, the lesions did not change in size and her symptoms continued. She was transferred to our hospital and underwent mesenteric biopsy for histopathology using abdominal laparotomy. The histopathological and immunohistological findings of the mesenteric specimen demonstrated lambda light chain deposition. Accordingly, the patient was finally diagnosed with AL amyloidoma with no evidence of systemic amyloidosis. After laparotomy, her general condition worsened because of complications of pneumonia and deep vein thrombosis. She died suddenly from acute myocardial infarction. We have concluded that abdominal aortic retroperitoneal and mesenteric AL amyloidoma may have very poor prognoses in accordance with previous reports. In addition, the size and location of AL amyloidoma directly influence the prognosis. We suggest that early histopathology is important for improving prognosis.http://dx.doi.org/10.1155/2016/4146030
collection DOAJ
language English
format Article
sources DOAJ
author Kazuhiro Yokota
Dai Kishida
Hidekazu Kayano
Masahide Yazaki
Yuki Shimada
Yuji Akiyama
Toshihide Mimura
spellingShingle Kazuhiro Yokota
Dai Kishida
Hidekazu Kayano
Masahide Yazaki
Yuki Shimada
Yuji Akiyama
Toshihide Mimura
A Case of Abdominal Aortic Retroperitoneal and Mesenteric Amyloid Light Chain Amyloidoma
Case Reports in Rheumatology
author_facet Kazuhiro Yokota
Dai Kishida
Hidekazu Kayano
Masahide Yazaki
Yuki Shimada
Yuji Akiyama
Toshihide Mimura
author_sort Kazuhiro Yokota
title A Case of Abdominal Aortic Retroperitoneal and Mesenteric Amyloid Light Chain Amyloidoma
title_short A Case of Abdominal Aortic Retroperitoneal and Mesenteric Amyloid Light Chain Amyloidoma
title_full A Case of Abdominal Aortic Retroperitoneal and Mesenteric Amyloid Light Chain Amyloidoma
title_fullStr A Case of Abdominal Aortic Retroperitoneal and Mesenteric Amyloid Light Chain Amyloidoma
title_full_unstemmed A Case of Abdominal Aortic Retroperitoneal and Mesenteric Amyloid Light Chain Amyloidoma
title_sort case of abdominal aortic retroperitoneal and mesenteric amyloid light chain amyloidoma
publisher Hindawi Limited
series Case Reports in Rheumatology
issn 2090-6889
2090-6897
publishDate 2016-01-01
description We report the case of a Japanese woman with amyloid light chain (AL) amyloidoma in the abdominal aortic retroperitoneum and mesentery. Irregular soft tissue mass lesions with calcification in the abdominal aortic retroperitoneum and mesentery were initially detected by computed tomography at another hospital. The lesions gradually compressed the duodenum, causing symptoms of bowel obstruction. The patient was clinically diagnosed with retroperitoneal fibrosis, and prednisolone was administered at a dose of 40 mg/day. However, the lesions did not change in size and her symptoms continued. She was transferred to our hospital and underwent mesenteric biopsy for histopathology using abdominal laparotomy. The histopathological and immunohistological findings of the mesenteric specimen demonstrated lambda light chain deposition. Accordingly, the patient was finally diagnosed with AL amyloidoma with no evidence of systemic amyloidosis. After laparotomy, her general condition worsened because of complications of pneumonia and deep vein thrombosis. She died suddenly from acute myocardial infarction. We have concluded that abdominal aortic retroperitoneal and mesenteric AL amyloidoma may have very poor prognoses in accordance with previous reports. In addition, the size and location of AL amyloidoma directly influence the prognosis. We suggest that early histopathology is important for improving prognosis.
url http://dx.doi.org/10.1155/2016/4146030
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