Table 2 Pathologic summary

From: Two types of amyloidosis presenting in a single patient: a case series

Case Tissue 1 Anatomic distribution Amyloid biopsy 1 Tissue 2 Interval (months) Anatomic distribution Amyloid biopsy 2 Focus of therapy
1 Stomach Interstitial = ATTR; Vascular = ATTR ATTR Fat 4 NA SAA Nil
2 Heart Interstitial = ATTR ATTR Fat 0 NA AIns ATTR
3 Kidney Vascular = AL AL (λ) BM 2 Periosteal fibrous tissue = ATTR ATTR AL
4 Heart Vascular = ATTR ATTR Duodenum 0 Interstitial = A-IA A-IA Nil**
5 BM Periosteal fibrous Tissue = AL & ATTR Hybrid AL (λ) and ATTR Fat 0 NA AL (λ) AL
6^ BM Periosteal fibrous tissue = AL & ATTR Hybrid AL (κ) and ATTR Lymph node 0 Globular = AL predominant AL (κ) predominant AL
7 Heart Vascular = AL; Interstitial = ATTR Predominant AL (λ) and ATTR* Kidney 4 Vascular = AL AL (λ) Nil***
8 BM Periosteal fibrous tissue = AL AL (κ) BM 130 Periosteal fibrous tissue = AL and ATTR Hybrid AL (κ) and ATTRm AL
9^^ Fat NA AL (λ) Heart 1 Vascular = AL and ATTR; interstitial = AL and ATTR Hybrid AL(λ) and ATTR AL and ATTR
  1. *Amyloid subtype varied depending on anatomic distribution. See Fig. 1
  2. **Amyloidoses were diagnosed postmortem
  3. ***Patient expired prior to institution of therapy
  4. ^Heart biopsy 6 years later demonstrated vascular involvement by AL (κ) predominant amyloid
  5. ^^Prostate biopsy from 4 years earlier was retrospectively analyzed for amyloid, demonstrating AL (λ) amyloid in a vascular distribution
  6. ATTR transthyretin amyloidosis, ATTRm hereditary transthyretin amyloidosis, AL immunoglobulin light chain amyloidosis, A-IA immunoglobulin-associated amyloidosis, SAA serum amyloid A amyloidosis, AIns insulin-derived amyloidosis, BM bone marrow