Asymptomatic Localized Gastric Amyloidosis with Two Separate Lesions
Korean J Helicobacter Up Gastrointest Res 2018;18(2):131-134
Published online June 10, 2018
© 2018 Korean College of Helicobacter and Upper Gastrointestinal Research.

Joo Hyun Lim1, Jung Kim2, Ji Yeon Seo1, Jung Ho Bae1

Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center1, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine2, Seoul, Korea
Correspondence to: Joo Hyun Lim
Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, 38∼40FL, Gangnam Finance Center, 152 Teheran-ro, Gangnam-gu, Seoul 06236, Korea
Tel: +82-2-2112-5807, Fax: +82-2-2112-5635, E-mail: joohyunlim@snuh.org
ORCID: https://orcid.org/0000-0002-8437-096X
Received December 18, 2017; Revised December 22, 2017; Accepted December 26, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Amyloidosis is a disease in which amyloid is abnormally accumulated in the tissue. The kidney and heart are the most commonly involved organs. Gastric involvement is relatively common in systemic disease; however, localized gastric amyloidosis is rare. Here, we report a case of localized gastric amyloidosis with two separate lesions. A 56-year-old woman underwent a health surveillance checkup without any noticeable symptoms. She was under medication for diabetes and dyslipidemia, and was otherwise healthy. On surveillance upper endoscopy, an irregularly shaped hyperemic elevated erosion at the gastric fundus and a 1.5-cm, yellowish subepithelial tumor-like lesion with intact overlying mucosa at the lesser curvature of the lower body of the stomach were detected. Endoscopic biopsy revealed submucosal eosinophilic material deposition in both lesions. Congo-red staining showed amyloid deposit appearing as a yellow-green birefringence under polarizing microscopy. Echocardiography, abdominal sonography, and colonoscopy revealed no abnormality. The patient was diagnosed as having localized gastric amyloidosis and is now undergoing regular follow-up without any treatment. Localized gastric amyloidosis is a rare disease that may mimic nonspecific gastritis or subepithelial tumor. However, endoscopic biopsy with appropriate staining may be diagnostic and thorough evaluation for systemic involvement is important.
Keywords : Amyloidosis; Endoscopy; Stomach


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