Localized Amyloidosis of the Upper Aerodigestive Tract: Complex Analysis of the Cellular Infiltrate and the Amyloid Mass

Figure 1

(a) HE staining, low power magnification. The photograph demonstrates the diffuse, infiltrating, type of amyloid deposition in biopsy material of patient 2. See how the eosinophilic amyloid material surrounds and embeds the mucus ducts. (b) HE staining. This midpower detail (patient 5) represents another form, the concentrically laminated nodular appearance of amyloid deposition. Note the occasional multinucleated giant cells (arrows) surrounding the nodules and the lymphoplasmacytic infiltrate in between. (c) Congo red staining, polarized light, high-power magnification. The biopsy specimen of patient 1 shows the laminated structure of the Congo red-positive amyloid nodules with apple-green birefringence. (d) λ immunohistochemical staining, midpower photograph, patient 1. Note the respiratory epithelium on the top and the immunopositive nodules showing different staining intensity and laminated structure. (e–h) Immunopositivity for amyloid A, P component, ApoAI, and prealbumin, respectively, in patient 4. Note the variable staining intensity in the amyloid material. (i, j) κ and λ mRNA-ISH on consecutive slides of patient 5. See the λ-dominant, centrally placed plasmacytic population in (j).

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(b)

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(e) Amyloid A

(f) Amyloid P component

(g) ApoAI

(h) Prealbumin

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(j)