title: Marked hepatomegaly due to AA type amyloidosis in a case with Castleman's disease.
abstract: Hepatic amyloidosis complicated with Castleman's disease is quite rare. A 48-year-old woman was referred to our hospital with general fatigue, low-grade fever, anemia, thrombocythemia, and liver dysfunction. Physical examination revealed anemia and hepatomegaly and abdominal computed tomography showed marked hepatomegaly and right upper abdominal masses. Technetium-99m pyrophosphate (99mTc-PYP) scintigraphy revealed the diffuse abnormal uptake of the enlarged liver, suggesting amyloid deposition. Liver biopsy showed destruction of the liver structure and the massive deposition of AA type amyloid protein. Surgical resection was performed on the abdominal masses. Histological examination of the masses showed Castleman's disease (plasma cell type). After resection, her fever resolved and the liver size gradually decreased to within the normal range. This case shows that surgical resection of the main lesion is effective for hepatomegaly due to AA type amyloidosis associated with Castleman's disease.
authors.affiliation: Department of Hematology, International Medical Center of Japan, Tokyo, Japan. yamagata@takanohara-ch.or.jp
authors.forename: Noboru
authors.initials: N
authors.lastname: Yamagata
authors.forename: Jyunko
authors.initials: J
authors.lastname: Fujio
authors.forename: Risen
authors.initials: R
authors.lastname: Hirai
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Matsumaru
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tanimura
authors.forename: Chiho
authors.initials: C
authors.lastname: Inokuchi
authors.forename: Tateki
authors.initials: T
authors.lastname: Shikai
authors.forename: Naoki
authors.initials: N
authors.lastname: Takezako
authors.forename: Michiyo
authors.initials: M
authors.lastname: Nasu
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Sakata
authors.forename: Naohiro
authors.initials: N
authors.lastname: Sata
authors.forename: Hideo
authors.initials: H
authors.lastname: Nagai
authors.forename: Ken
authors.initials: K
authors.lastname: Saito
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Miwa
mesh_terms: D000686:Amyloidosis / Q000150:complications* / Q000378:metabolism / Q000473:pathology*; D005871:Castleman Disease / Q000150:complications* / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006529:Hepatomegaly / Q000150:complications / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D010950:Plasma Cells / Q000378:metabolism / Q000473:pathology; D000685:Serum Amyloid A Protein / Q000378:metabolism
chemical_list: D000685:Serum Amyloid A Protein