Amyloid in biopsies of the gastrointestinal tract-a retrospective observational study on 542 patients.

In this retrospective observational study, we investigated the histopathological and demographic characteristics of amyloid in gastrointestinal biopsies. From the Amyloid Registry Kiel, we retrieved all cases with amyloid in biopsies of the stomach, duodenum, small intestine, large intestine, and re...

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Published in:Virchows Archiv: European Journal of Pathology Vol. 468; no. 5; pp. 569 - 578
Main Authors: Freudenthaler, Sophie, Hegenbart, Ute, Schönland, Stefan, Behrens, Hans-Michael, Krüger, Sandra, Röcken, Christoph
Format: pictorial research tables/charts Journal Article
Published: Springer Nature May2016
Online Access:View this record in EBSCOhost
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      dt: May2016
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      pub: Springer Nature
      place: New York, New York
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        atl: Amyloid in biopsies of the gastrointestinal tract-a retrospective observational study on 542 patients.
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          Freudenthaler, Sophie
          Hegenbart, Ute
          Schönland, Stefan
          Behrens, Hans-Michael
          Krüger, Sandra
          Röcken, Christoph
        affil: Department of Pathology, Christian-Albrechts-University, Arnold-Heller-Str. 3, Haus 14 24105 Kiel Germany
      sug:
        subj:
          Amyloidosis Pathology
          Amyloidosis Epidemiology
          Gastrointestinal System Metabolism
          Gastrointestinal System Pathology
          Aged
          Female
          Male
          Immunohistochemistry Methods
          Proteins Metabolism
          Aged, 80 and Over
          Biopsy
          Retrospective Design
          Prevalence
          Adolescence
          Young Adult
          Middle Age
          Adult
          Human
          Aged: 65+ years
          Aged, 80 & over
          Adolescent: 13-18 years
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Female
          Male
      ab: In this retrospective observational study, we investigated the histopathological and demographic characteristics of amyloid in gastrointestinal biopsies. From the Amyloid Registry Kiel, we retrieved all cases with amyloid in biopsies of the stomach, duodenum, small intestine, large intestine, and rectum submitted for tertiary referral between January 2003 and April 2013. Amyloid was identified by Congo red staining in combination with polarization microscopy and classified by immunohistochemistry. The TTR-genotype was assessed in 56 patients. Amyloid type was correlated with demographic patient characteristics. Six hundred sixty-three biopsies from 542 patients were retrieved. Amyloid was found in each biopsy as vascular and/or interstitial amyloid deposits. Biopsies were obtained from the colon [254 biopsies (38.3 %)], stomach, [153 (23.1 %)], rectum [112 (16.9 %)], duodenum [105 (15.8 %)], and jejunum/ileum [39 (5.9 %)]. ALλ amyloid was found in 286 (52.8 %), ATTR in 88 (16.2 %), ALκ in 74 (13.7 %), AA in 58 (10.7 %), and ApoAI amyloid in 4 (0.7 %) patients. The remaining 21 cases were ALys amyloid in 4 (0.7 %), AL n.o.s. in 14 (2.6 %), and mixed type amyloidosis in 3 (0.6 %). The amyloid of 11 (2.0 %) cases remained unclassified. The median age of the patients was 68 years. Men [332 (61.7 %)] were significantly more prevalent than women [206 (38.3 %); p < 0.001]. TTR mutations were found in 24 % of the patients with ATTR amyloidosis. The median age, the histoanatomical distribution (proximal to distal; mucosal to submucosal), and the deposition pattern (vascular/interstitial) varied between different amyloid types. Amyloid in gastrointestinal biopsies mainly affects male elderly patients and shows amyloid-type-specific demographic patient characteristics.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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