A case of primary systemic amyloidosis with amyloid deposits in the duodenum and bone marrow aspirate: A rare finding

Abstract

Amyloidosis is a group of diseases characterized by extracellular abnormal proteinaceous material (amyloid) deposition in various organs. As amyloid fibrils accumulate, tissues and organs may fail to function properly. Evidence of amyloid deposition in duodenal biopsies and bone marrow (BM) aspirates is uncommon and often overlooked. Here, we present a patient diagnosed with primary systemic amyloidosis who complained of pain in the abdomen, vomiting, loose stools, and generalized weakness. Histological examination of an endoscopic duodenal biopsy revealed amyloid deposits. BM aspiration cytology revealed amyloid deposition with BM plasmacytosis. She was eventually diagnosed with plasma cell dyscrasia based on a series of biochemical tests. To the best of our knowledge, reports of simultaneous amyloid deposition in the duodenum and BM aspirate smears are very rare and unpublished. This case serves to highlight the significance of careful microscopic histo-cytology and the utility of special stains for prompt diagnosis and treatment outcomes in a disease of poor prognosis.