Marked hepatomegaly due to AA type amyloidosis in a case with Castleman's disease.
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.
Yamagata
Noboru
N
Department of Hematology, International Medical Center of Japan, Tokyo, Japan. yamagata@takanohara-ch.or.jp
Fujio
Jyunko
J
Hirai
Risen
R
Matsumaru
Mutsumi
M
Tanimura
Satoshi
S
Inokuchi
Chiho
C
Shikai
Tateki
T
Takezako
Naoki
N
Nasu
Michiyo
M
Sakata
Yoichi
Y
Sata
Naohiro
N
Nagai
Hideo
H
Saito
Ken
K
Miwa
Akiyoshi
A
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
D000685:Serum Amyloid A Protein