case_images: PMC10676274_01
case_images: Bulky tongue reaching to the back surface of oropharynx causing obliteration of communication between nasopharynx and oropharynx (MRI of cervical region and cranium: (a) coronal view; (b) sagittal view).
case_images: CRIE2023-5583344.001.jpg
case_images: PMC10676274_01_CRIE2023-5583344.001.jpg
case_images: fig1
case_images: The radiogram of both hands.
case_images: CRIE2023-5583344.002.jpg
case_images: PMC10676274_01_CRIE2023-5583344.002.jpg
case_images: fig2
case_images: From other significant image findings, a palmar radiograph showed a marked thickness of the periosteum, primarily of the proximal phalanges, with a marginal width of slightly more than 12 mm (Figure 2), and magnetic resonance imaging (MRI) of the hypothalamic-pituitary area showed reduction of pituitary parenchyma with incompetence of the diaphragm of sellae, more precisely partially empty sellae (Figure 3).
case_images: Sagittal MRI view of hypothalamic-pituitary area showed reduction of pituitary parenchyma.
case_images: CRIE2023-5583344.003.jpg
case_images: PMC10676274_01_CRIE2023-5583344.003.jpg
case_images: fig3
case_images: From other significant image findings, a palmar radiograph showed a marked thickness of the periosteum, primarily of the proximal phalanges, with a marginal width of slightly more than 12 mm (Figure 2), and magnetic resonance imaging (MRI) of the hypothalamic-pituitary area showed reduction of pituitary parenchyma with incompetence of the diaphragm of sellae, more precisely partially empty sellae (Figure 3).
case_images: HE staining, magnification 4x: histologically, clusters of homogeneous eosinophilic material, also known as amyloid (A), can be seen in the mucosa, in the wall of smaller veins (V) and in the connective tissue between muscles (M).
case_images: CRIE2023-5583344.004.jpg
case_images: PMC10676274_01_CRIE2023-5583344.004.jpg
case_images: fig4
case_images: The pathohistological sample was subjected to green birefringence on polarization microscopy after Congo red staining, which corresponds to the diagnosis of amyloidosis (Figures 4-6).
case_images: Congo red, 4x magnification; when dyeing with Congo red, the material is dyed bright red.
case_images: CRIE2023-5583344.005.jpg
case_images: PMC10676274_01_CRIE2023-5583344.005.jpg
case_images: fig5
case_images: The pathohistological sample was subjected to green birefringence on polarization microscopy after Congo red staining, which corresponds to the diagnosis of amyloidosis (Figures 4-6).
case_images: Congo staining, 20x magnification; under polarized light, the material gives positive birefringence and is greenish in color.
case_images: CRIE2023-5583344.006.jpg
case_images: PMC10676274_01_CRIE2023-5583344.006.jpg
case_images: fig6
case_images: The pathohistological sample was subjected to green birefringence on polarization microscopy after Congo red staining, which corresponds to the diagnosis of amyloidosis (Figures 4-6).
case_images: PMC10676274_02
case_images: CT of thoracic organs showing an expansive formation with infiltration of the costal pleura in the lower right lung lobe accompanied with a nodular formation which seemed to most likely correspond to metastasis.
case_images: CRIE2023-5583344.007.jpg
case_images: PMC10676274_02_CRIE2023-5583344.007.jpg
case_images: fig7
case_images: As an additional finding, multiple liver hemangiomas and nodular formations of the left and right adrenal glands, which seem to correspond to secondary lesions, were described (Figure 7).