Obstructive jaundice caused by the deposition of amyloid-like substances in the extrahepatic and large intrahepatic bile ducts in a patient with multiple myeloma.
Obstructive jaundice has rarely been reported in liver amyloidosis. We report here an autopsy of a 55-year-old woman with multiple myeloma and obstructive jaundice due to the deposition of amyloid-like substances in the walls and lumina of the extrahepatic bile duct and intrahepatic large bile ducts, resulting in obstruction and narrowing of the bile ducts. The amyloid-like deposits were negative with Congo red stain, and were negative immunohistochemically for IgG, IgA, IgM, kappa chain, beta-2-microglobulin, and amyloid A and P components. However, they were positive for lambda chain, and ultrastructurally composed of non-branching filaments with a diameter of 7-10 nm. This is the first case of obstructive jaundice due to histologically confirmed amyloid-like deposits in the biliary system.
Terada
T
T
Department of Pathology (II), Kanazawa University School of Medicine, Japan.
Hirata
K
K
Hisada
Y
Y
Hoshii
Y
Y
Nakanuma
Y
Y
D000682:Amyloid / Q000032:analysis; D000686:Amyloidosis / Q000150:complications* / Q000473:pathology; D017734:Bile Ducts, Extrahepatic / Q000737:chemistry / Q000473:pathology*; D001651:Cholestasis, Extrahepatic / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D002780:Cholestasis, Intrahepatic / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000473:pathology*
D000682:Amyloid