Light-chain amyloidosis presenting with rapidly progressive submucosal hemorrhage of the stomach.
The gastrointestinal tract is frequently in involved light-chain (AL) amyloidosis, but significant hemorrhagic complications are rare. A 71-year-old man presented to our hospital with dyspepsia and heartburn for 1 month. Gastroscopy revealed a large submucosal hematoma at the gastric fundus. Two days later, a follow-up gastroscopy indicated extensive expansion of the hematoma throughout the upper half of the stomach. The hematoma displayed ongoing expansion during the endoscopic examination, suggesting that rupture was imminent. Emergency total gastrectomy was performed, and amyloidosis was confirmed after examining the surgical specimen. Bone marrow examination revealed multiple myeloma, and serum immunoglobulin assay confirmed the diagnosis of myeloma-associated AL amyloidosis. At manuscript submission, the patient was doing well and was undergoing chemotherapy.
Department of Surgery, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea.
Song-Yi
SY
Kim
Department of Surgery, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea.
Suk-Bae
SB
Moon
Department of Pathology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea.
Seung Koo
SK
Lee
Department of Surgery, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea.
Seong Kweon
SK
Hong
Department of Surgery, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea.
Yang Hee
YH
Kim
Department of Surgery, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea.
Gi Bong
GB
Chae
Department of Surgery, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea. Electronic address: bsb1971_kr@kangwon.ac.kr.
Sung-Bae
SB
Park
D000368:Aged; D000686:Amyloidosis / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D018450:Disease Progression; D005743:Gastrectomy; D005753:Gastric Mucosa; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007147:Immunoglobulin Light Chains; D008297:Male; D013272:Stomach Diseases / Q000209:etiology* / Q000601:surgery
D007147:Immunoglobulin Light Chains
amyloidosis; hemorrhage; stomach