Obstructive jaundice caused by the deposition of amyloid-like substances in the extrahepatic and large intrahepatic bile ducts in a patient with multiple myeloma

Histopathology. 1994 May;24(5):485-7. doi: 10.1111/j.1365-2559.1994.tb00560.x.

Abstract

Obstructive jaundice has rarely been reported in liver amyloidosis. We report here an autopsy of a 55-year-old woman with multiple myeloma and obstructive jaundice due to the deposition of amyloid-like substances in the walls and lumina of the extrahepatic bile duct and intrahepatic large bile ducts, resulting in obstruction and narrowing of the bile ducts. The amyloid-like deposits were negative with Congo red stain, and were negative immunohistochemically for IgG, IgA, IgM, kappa chain, beta-2-microglobulin, and amyloid A and P components. However, they were positive for lambda chain, and ultrastructurally composed of non-branching filaments with a diameter of 7-10 nm. This is the first case of obstructive jaundice due to histologically confirmed amyloid-like deposits in the biliary system.

Publication types

  • Case Reports

MeSH terms

  • Amyloid / analysis
  • Amyloidosis / complications*
  • Amyloidosis / pathology
  • Bile Ducts, Extrahepatic / chemistry
  • Bile Ducts, Extrahepatic / pathology*
  • Cholestasis, Extrahepatic / etiology*
  • Cholestasis, Extrahepatic / metabolism
  • Cholestasis, Extrahepatic / pathology
  • Cholestasis, Intrahepatic / etiology*
  • Cholestasis, Intrahepatic / metabolism
  • Cholestasis, Intrahepatic / pathology
  • Female
  • Humans
  • Middle Aged
  • Multiple Myeloma / complications
  • Multiple Myeloma / pathology*

Substances

  • Amyloid