Clinical Recognition of AL Type Amyloidosis of the Luminal Gastrointestinal Tract  Dustin G. James, Gary R. Zuckerman, Gregory S. Sayuk, Hanlin L. Wang, Chandra Prakash  Clinical Gastroenterology and Hepatology  Volume 5, Issue 5, Pages 582-588 (May 2007) DOI: 10.1016/j.cgh.2007.02.038 Copyright © 2007 AGA Institute Terms and Conditions

Figure 1 Endoscopic and histologic findings of submucosal hematomas associated with AL amyloidosis. (A and B) Endoscopic appearance of submucosal hematomas. Lesions ranged in size from 5 mm to 3 cm, and 1–5 were found in individual patients. (C) Histologic examination of a biopsy from a submucosal hematoma in the colon revealed mucosal hemorrhages and deposition of amorphous material in the submucosa (hematoxylin-eosin stain; original magnification, 100×). (D) The same biopsy examined under polarized light with Congo red stain revealed apple-green birefringence, typical of amyloid. Mucosal hemorrhages, staining red, were seen atop the amyloid deposition (original magnification, 100×). Clinical Gastroenterology and Hepatology 2007 5, 582-588DOI: (10.1016/j.cgh.2007.02.038) Copyright © 2007 AGA Institute Terms and Conditions

Figure 2 Pathologic findings of AL type amyloidosis of the luminal gastrointestinal tract. (A) Histologic examination of a jejunal biopsy from a patient who presented with pseudo-obstruction revealed amorphous material diffusely replacing the entire mucosa and extensively involving the submucosal blood vessels. Only residual surface lining epithelial cells remained (hematoxylin-eosin stain; original magnification, 200×). (B) The same biopsy examined under polarized light with Congo red stain revealed apple-green birefringence, typical of amyloid (original magnification, 200×). Clinical Gastroenterology and Hepatology 2007 5, 582-588DOI: (10.1016/j.cgh.2007.02.038) Copyright © 2007 AGA Institute Terms and Conditions