Mass Spectrometry Amyloid Typing Is Reproducible across Multiple Organ Sites

Table 2

Amyloid typing based on IHC and proteomic analysis.

Case	Tissue	IHC: Basic panel of					IHC: Expanded panel of			Proteomic typing	Consensual typing
		Ig κ	Ig λ	SAA	TTR	IHC typing	Ig κ	Ig λ	IHC typing
1	Heart	-	-	-	-	-	++	-	AL κ	AL κ
	Liver	-	+/-	-	-	AL λ	+	-	NS	AL κ
2	Heart	+	-	+/++	+	AA	++	+	NS	AL κ
	Tongue	+	-	++	++	NS	++	+	NS	AL κ
3	Heart	-	-	-	+/++	ATTR	++	-	NS	AL κ
	Liver	-	-	-	+	ATTR	+	-	NS	AL κ
4	Heart	+	-	-	+	NS	++	-	AL κ	AL κ
	Liver	+	-	-	+	NS	++	-	AL κ	AL κ
5	Heart	++	-	-	-	AL κ	++	+/-	AL κ	AL κ
	Small intestine	+	-	+	-	NS	+	-	NS	AL κ
6	Heart	-	+	-	-	AL λ	-	++	AL λ	AL λ
	Liver	-	+	-	-	AL λ	+	++	AL λ	AL λ
7	Heart	-	++	-	++	NS	++	+++	AL λ	AL λ
	Liver	-	++	-	++	NS	++	++	NS	AL λ
8	Heart	-	++	-	+	AL λ	+	+++	AL λ	AL λ
	Kidney	-	++	-	+/-	AL λ	+	+++	AL λ	AL λ
9	Heart	-	+	-	-	AL λ	-	++	AL λ	AL λ
	Liver	-	++	-	-	AL λ	-	+	AL λ	AL λ
10	Heart	-	++/+++	+/++	++/+++	NS	+	++	NS	AL λ
	Kidney	-	+/++	+/++	++	NS	++	++	NS	AL λ
11	Heart	-	++	+	+/++	NS	+/-	++	AL λ	AL λ
	Liver	-	++	-	+/++	NS	-	+	NS	AL λ

Ig κ, immunoglobulin light chain kappa; Ig λ, immunoglobulin light chain lambda; NS, no immunospecific staining; SAA, serum amyloid A; TTR, transthyretin; AL κ, amyloidosis derived from immunoglobulin light chain kappa; AL λ, amyloidosis derived from immunoglobulin light chain lambda; AA, amyloidosis derived from serum amyloid A; ATTR, amyloidosis derived from transthyretin.
The intensity of IHC staining was classified as negative (-), weak (+), moderate (++), and strong (+++). The higher IHC reaction is defining the IHC typing.
Antibodies from DAKO.
Antibodies from amYmed.