Localised gastric amyloidosis presenting as a bleeding ulcerated mass lesion - a case study

Abstract

BACKGROUND: Amyloidosis is a rare disease characterised by the accumulation of abnormal fibrillar proteins (amyloid) in body tissues; most commonly kidneys, heart and live1.1 Gastrointestinal amyloidosis especially with a localised isolated gastric presentation is rare.2 In this disease, amyloid proteins accumulate most commonly in the gastric body. Aim(s): To highlight the clinical and histological findings of localised gastric amyloidosis by examining a case of an 81-year-old woman presenting with abdominal pain and upper GI bleeding in the context of an ulcerated gastric mass lesion. METHODS: Paraffin sections were taken and stained for H&E, Congo Red and immunohistochemical stains for subtyping the amyloid deposits. RESULTS: The examined slides showed a gastric ulcer with tumefactive amyloid deposition amidst fibrin and exudate. Immunohistochemistry results showed a non-AA type of amyloid in the deposits. DISCUSSIONS: Although uncommon, amyloidosis should be considered in the context of ulcerated gastric mass lesions and upper GI bleeding. The current treatment involves a conservative approach with regular gastroscopy and excision of identified deposits. Further studies are needed in the future to ascertain the precise pathophysiology and create targeted treatment strategies.