Recurrent gastric hemorrhaging with large submucosal hematomas in a patient with primary AL systemic amyloidosis: endoscopic and histopathological findings.
A 64-year-old woman who suffered intractable gastric ulcers with hemorrhaging showed huge submucosal hematomas in her stomach on the endoscopic examination. Since gastric mucosal biopsy revealed amyloid deposition and IgG lambda type M protein was detectable in her serum, she was diagnosed as having primary AL systemic amyloidosis. The gastric hemorrhages did not improve despite intensive medication, so total gastrectomy was performed, resulting in an unfavorable outcome. Massive deposition of amyloid with A lambda immunoreactivity was seen on the submucosal vessels in her stomach. This is a rare primary AL systemic amyloidosis case showing recurrent and fatal gastric submucosal hematomas.
Iijima-Dohi
Naoko
N
Department of Medicine, Suwa Red Cross Hospital, Suwa.
Shinji
Akihiro
A
Shimizu
Toshiki
T
Ishikawa
Sho-Zou
SZ
Mukawa
Kenji
K
Nakamura
Tomotugu
T
Maruyama
Keiko
K
Hoshii
Yoshinobu
Y
Ikeda
Shu-Ichi
S
D000686:Amyloidosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D005773:Gastroscopy; D006406:Hematoma / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D013272:Stomach Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D013276:Stomach Ulcer / Q000175:diagnosis / Q000209:etiology / Q000601:surgery