A 57-year-old male patient with a personal history of hypertension and hepatitis C was diagnosed with solitary bone voiding cystoma in a rib, who had multiple myeloma and multiple myeloma.
She had been on peritoneal dialysis for 5 years due to chronic renal failure secondary to nephropathy associated with multiple myeloma.
He consulted for several lesions in the tongue and left lower lip, of 2 months of evolution that produced important scott.
On examination five nodular lesions are observed at the tip of the tongue, lateral face of the tongue and left lip.
Three of the nodules had a violaceous color with the center slightly white and the other two, clearer, without tapering.
The consistency of the consolidation was something indurated.
The nodule on the lateral side of the tongue had a diameter greater than 1.5 cm, on the lip, the largest was 1.2 cm and the size of the rest of the nodules was lower than these measurements.
One month after the oral examination, the patient came again, presenting purpura bilateral periocular lesions.
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A total of 3 biopsies, one from the lip and two from the lingual lesions were performed.
These biopsies are described as dense deposits of hyaline, acellular, homogeneous material occupying the entire submucosa separating muscle bundles with involvement of vascular walls.
These deposits are stained with Congo Red staining and presented a fresh green birefringence.
In addition, yellowish-green fluorescence is observed with staining of tiovin T.
Acanthosis with parakeratosis and a mild lymphoplasmacytic infiltrate are observed in the rest of the mucosa.
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Once the findings were observed, an abdominal fat needle aspiration biopsy was requested, which was positive for amyloid material with Congo Red staining.
The diagnosis of systemic amyloidosis is confirmed with this, and different tests are carried out aiming at a multiorgan alteration, with involvement of skin, nervous tissue, gastrointestinal system, heart and kidney.
Fifteen months after the diagnosis of amyloidosis, the patient died due to a megacolon and multiple organ failure.
