Hidden amyloidosis in liver and bone marrow

Abstract

Primary amyloidosis and multiple myeloma (MM) involve clonal plasma cell proliferation. Approximately 10–15% of patients with amyloidosis have MM. Characteristic apple-green birefringence using Congo red staining on polarized microscopy confirms amyloid. MM is prevalent at ages from 60 to 70 years. Amyloidosis commonly affects the heart, kidneys, gastrointestinal tract/liver and peripheral or autonomic nervous system predicting a poor prognosis due to organ deterioration. This case highlights the importance of diagnosing amyloidosis in a 60-year-old female where plasma cells were present in the liver and bone marrow along with amyloid deposits and for early initiation of intense chemotherapy.