PMC4899645_01
a Large tumor on the left side of the head (male, 79 years). b-d The waxy tumor exhibited a sulcated, mostly yellowish and reddish surface, and in some areas hemorrhages. A punch biopsy showed amorphous eosinophilic material in the dermis (b), and these masses extended down to the subcutis. Immunohistochemistry showed that the entire dermis and parts of the subcutis were filled with amyloid consisting of both kappa and lambda immunoglobulin light chains (c, d). e In electron microscopy, the typical amyloid fibrils (7-10 nm in diameter) were found (bar = 0.5 microm).
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F1
A 79-year-old man presented with a large tumor on the left side of his head (fig. 1a), which had grown over 5 years. Histology showed that nearly the entire dermis was filled with amorphous eosinophilic material (fig. 1b), and these masses extended down to the subcutis. Immunohistochemistry was negative for cytokeratin, but showed that the entire dermis and parts of the subcutis were filled with amyloid consisting of both kappa and lambda immunoglobulin light chains (fig. 1c, d). In electron microscopy, the typical amyloid fibrils (7-10 nm in diameter) were found (fig. 1e).
The patient at follow-up 1 month after surgery. He showed no signs of local tumor recurrence or systemic disease.
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F2
The tumor was completely removed via curettage (fig. 2).