Localized intestinal AL amyloidosis detected as bright green using autofluorescence endoscopy
Localized intestinal AL amyloidosis detected as bright green using autofluorescence endoscopy
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DOI：
10.1007/s12328-021-01378-7
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发表时间：
2021-04-26
影响因子：
1
通讯作者：
Masamune, Atsushi
中科院分区：
文献类型：
--
作者：
Kuroha, Masatake;Yoshinaga, Tsuneaki;Masamune, Atsushi
淀粉样变性可分为全身性的，淀粉样蛋白沉积在全身的器官中，或局限性的，仅涉及一个器官。局限于肠道的淀粉样变性是罕见的。本报告描述了三例局限性AL淀粉样变性在肠道，并介绍了他们的临床特点，内镜检查结果，和消化道。这三个病例都没有症状，是在粪便潜血试验阳性后进行内窥镜检查时意外发现的。内镜检查结果包括斑片状发红和蜿蜒扩张的血管病变。自体荧光（AFI）内镜下，淀粉样蛋白沉积病灶呈亮绿色强化。我们使用荧光显微镜观察未染色的标本从淀粉样蛋白沉积部位与激发光。在淀粉样蛋白沉积病变部位，用宽激发波长检测自体荧光。结果显示，AL淀粉样蛋白具有自体荧光，AFI内窥镜检测时呈亮绿色。3例病例均未观察到系统性淀粉样变性或器官衰竭。所有病例的长期病程均良好。
Amyloidosis is classifiable as systemic, with amyloid deposition in organs throughout the body, or localized, involving only one organ. Amyloidosis localized in the intestinal tract is rare. This report describes three cases of localized AL amyloidosis in the intestinal tract and presents their clinical characteristics, endoscopic findings, and prognoses. All three cases were asymptomatic, and were found accidentally during endoscopy for closer examination after a positive fecal occult blood test. Endoscopic findings included patchy redness and meandering dilated vessels of the lesion. Using autofluorescence (AFI) endoscopy, the lesion of amyloid deposition was enhanced as bright green. We used fluorescence microscopy to observe unstained specimens obtained from an amyloid deposition site with excitation light. Autofluorescence was detected with the broad excitation wavelength at amyloid deposition lesion sites of the specimen. Results revealed that AL amyloid has autofluorescence that engenders its detection by AFI endoscopy as bright green. In none of the three cases was systemic amyloidosis or organ failure observed. The long-term course of all the cases was favorable.