title: Liver AL amyloidosis as a possible cause of high liver stiffness values.
abstract: The liver is a common site of amyloid deposition in primary systemic amyloidosis. We report the case of a 52-year-old white woman complaining of hepatomegaly, high levels of alkaline phosphatase and serum gamma-glutamyl transferase. Other laboratory tests showed proteinuria with light-chain type lambda. Color Doppler ultrasonography showed an enlarged bright liver with hepatopetal portal blood flow. Fine-needle aspiration biopsy of abdominal fat, with Congo red stain, was positive for amyloid. No liver biopsy was performed, but transient elastography showed high liver stiffness values (75 kPa), suggestive of amyloid infiltration, as other causes of elevation had been ruled out by clinical, laboratory and radiological findings. Bone marrow morphology and immunoistochemistry confirmed low-grade plasmacytoma with amyloidosis.
authors.affiliation: Division of Internal Medicine-Bolondi, Department of Diseases of the Digestive System and Internal Medicine, University of Bologna, Bologna, Italy.
authors.forename: Arianna
authors.initials: A
authors.lastname: Lanzi
authors.forename: Alice
authors.initials: A
authors.lastname: Gianstefani
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Mirarchi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Pini
authors.forename: Fabio
authors.initials: F
authors.lastname: Conti
authors.forename: Luigi
authors.initials: L
authors.lastname: Bolondi
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D000686:Amyloidosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D044963:Biopsy, Fine-Needle; D054459:Elasticity Imaging Techniques; D005260:Female; D006529:Hepatomegaly / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D010954:Plasmacytoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D011507:Proteinuria / Q000150:complications; D018615:Ultrasonography, Doppler, Color; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase