title: Head and neck amyloidosis: clinicopathological features and immunohistochemical analysis of 14 cases.
abstract: BACKGROUND
  Amyloidosis is associated with or caused by amyloid deposition. These fibrillar proteins may be deposited extracellularly causing tissue damage or impairment.
  
  
  OBJECTIVE
  The aim of the study was to retrospectively review pathology archives in two oral diagnostic centers for cases fulfilling criteria of amyloidosis and to differentiate AA and AL types of amyloidosis.
  
  
  METHODS
  The clinicopathological features, alkaline Congo red staining, with and without pretreatment with potassium permanganate, and immunohistochemical (IHC) staining with anti-AA, anti-kappa (κ), and anti-lambda (λ) light chain antibodies were carried out and analyzed.
  
  
  RESULTS
  The search identified 14 cases. Ten patients were women and four were men, with a mean age of 58 years. Eleven patients had systemic involvement by amyloidosis (associated either with multiple myeloma or plasma cell dyscrasia/monoclonal gammopathies), while three presented the localized type, one of them associated with plasmacytoma. All cases showed positivity for κ or λ light chains (AL-amyloid) and presented resistance to the potassium permanganate pretreatment.
  
  
  CONCLUSIONS
  Our results show that the head and neck region is preferentially affected by systemic AL-amyloidosis, usually associated with plasma cell dyscrasia. Interestingly, two cases affected by inflammatory rheumatic diseases presented AL-amyloid deposition. Moreover, even after pretreatment with potassium permanganate, which was helpful in highlighting the presence of AL-amyloid, in agreement with the IHC findings, clinical classifications should be carefully made in systemic amyloidosis.
authors: Department of Oral Diagnosis - Oral Semiology and Oral Pathology Sections, Piracicaba Dental School - State University of Campinas, Piracicaba, Sao Paulo, Brazil. adrielefg@yahoo.com.br
authors: Adriele Ferreira
authors: AF
authors: Gouvêa
authors: Ana Carolina Prado
authors: AC
authors: Ribeiro
authors: Jorge Esquiche
authors: JE
authors: León
authors: Román
authors: R
authors: Carlos
authors: Oslei Paes
authors: OP
authors: de Almeida
authors: Márcio Ajudarte
authors: MA
authors: Lopes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000682:Amyloid / Q000032:analysis; D000686:Amyloidosis / Q000150:complications / Q000473:pathology*; D004396:Coloring Agents; D003224:Congo Red; D005145:Face; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000032:analysis; D007146:Immunoglobulin lambda-Chains / Q000032:analysis; D007202:Indicators and Reagents; D008047:Lip Diseases / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000150:complications; D009059:Mouth Diseases / Q000473:pathology*; D009101:Multiple Myeloma / Q000150:complications; D009333:Neck / Q000473:pathology; D010159:Palate / Q000473:pathology; D010265:Paraproteinemias / Q000150:complications; D011196:Potassium Permanganate; D012189:Retrospective Studies; D000685:Serum Amyloid A Protein / Q000032:analysis; D014060:Tongue Diseases / Q000473:pathology
chemical_list: D000682:Amyloid; D004396:Coloring Agents; D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains; D007202:Indicators and Reagents; D000685:Serum Amyloid A Protein; D011196:Potassium Permanganate; D003224:Congo Red