A Clinico-Pathological Study on Hepatic Amyloidosis

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  • 肝アミロイドーシスの臨床病理学的検討

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Fourteen autopsy cases of hepatic amyloidosis associated with systemic amyloidosis were presented for clinico-pathologic studies. Clinical types of the cases were classified as follows; primary type 4 cases, myeloma-associated type 3 cases, secondary type 5 cases, and 2 cases of familial amyloidosis. Among the laboratory data, abnormal transaminase values were recognized in only 4 cases (28.8%), however, markedly increased serum alkaline phosphatase activity was noted in 11 cases (78.6%). Constituent protein and deposition-site of amyloid were thoroughly investigated. Deposition of AL protein in Disse's space and periportal arterial wall was detected in primary and myeloma-associated amyloidosis. In secondary amyloidosis, the amyloid consisted chiefly of AA protein and its deposition was limited in only periportal arterial wall. It should be mentioned that these findings were not consistent with descriptions in bygone textbooks of pathology. Overt jaundice was found in 2 cases, in which the amyloid deposition was most prominent in the peripheral lobular zone, and hepatocellular atrophy was most remarkable in the same zone. The pathogenesis of overt jaundice in hepatic amyloidosis, therefore, could be incriminated as intrahepatic cholestasis due to hepatocellular compression atrophy which interfered with the bile-canalicular passage.

Journal

  • Kitasato medicine

    Kitasato medicine 16 (6), 366-373, 1986-12-31

    Kitasato University

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