Amyloidosis, nodular

Case 832 (M. Hurt) F 63 ear cutaneous horn – 1ry cut. amyloid of external ear 

Nodular amyloid in papillary dermis.  Check with CK5 or 34BE12, because basophilic degenerate collagen can be Congo Red +ve. 

Ref: Wenson SF. J Cutan Pathol 2012; 39(2): 263-9. 

Case 1370 (H. Diwan)  F 80 nodule leg (*teaching) 

Case 1471 (R. Carr)  M 50 sub-cutaneous lump   “amyloidoma” 

Large amorphous pink lump with areas of calcification and GC’s.  Could be AA amyloid secondary to degenerating pilomatrixoma, or secondary to insulin injections.  Lymphoid and plasmacytic aggregates prompted check for κ and λ restriction check – polytypic. 

Case 1583  20.7.16 (H. Diwan)  M 63 papules all over body 

Histol not well demonstrated (? slides missing).  However, good demo of Thioflavin-T fluorescence 

Case 1638 (H. Diwan) M 59 scalp. H/O renal cell carcinoma 

Massive pink deposits with haemorrhage.  ThioflavinT fluorescence 

Case 1866 (L. Yu) F 78 ear canal 

Nodular.  Congo Red and Crystal Violet stains.  Patient had myeloma. 

Case 2501 (S. Taibjee)   M 65 nodule by nose  (*teaching) 

Good histol.  Lamda restriction; Congo red +ve. 

Case 2320 (H. Diwan)  F 59 elbow 

Obvious fibrillary pattern to the amyloid.  Lots of haemorrhage. Plasma cells – apparently in keeping.  Progression to systemic disease uncommon. 

Case 2915 (U. Sundram)  M 65 long-standing lesions on lower legs 

Rather old, dried-out slide.  Tinctural changes I thought could be artefactual but were, in fact, dermal amyloid deposits.  Small cluster of plasma cells were light chain restricted i.e. amyloidosis associated with plasma cell dyscrasia 

Case 4166 (M. Abdel-Halim)  F 60 nodular infiltrative lesions on legs 

Patient with multiple myeloma.  Homogenous eosinophilic material showing apple-green birefringence. 

Case 4488 (Ravi Suchak) M 62 plaque on cheek