PMC4637487_01
Cardiac amyloidosis. (A) Congo red stain of left ventricle showing focal positive staining (red-orange) of amorphous extracellular material, 400x. (B) Congo red stain of left ventricle showing apple-green birefringence under polarized light, diagnostic of amyloid, 400x.
CRIONM2015-917157.001.jpg
PMC4637487_01_CRIONM2015-917157.001.jpg
fig1
Autopsy revealed IgG-kappa amyloid deposits in the left and right ventricles (Figure 1), the diaphragm (Figure 2), and the gastroesophageal junction (Figure 3).
Diaphragmatic amyloidosis. (A) Congo red stain of diaphragm showing diffuse positive staining (red-orange) of amorphous extracellular material, 200x. (B) Congo red stain of diaphragm showing apple-green birefringence under polarized light, 200x. (C) Kappa light chain immunostain of diaphragm showing diffuse positivity, diagnostic of kappa amyloid light chain amyloidosis, 20x. (D) Negative lambda light chain immunostain of diaphragm, 20x.
CRIONM2015-917157.002.jpg
PMC4637487_01_CRIONM2015-917157.002.jpg
fig2
Autopsy revealed IgG-kappa amyloid deposits in the left and right ventricles (Figure 1), the diaphragm (Figure 2), and the gastroesophageal junction (Figure 3).
Gastroesophageal junction amyloidosis. (A) Hematoxylin and eosin stain of gastroesophageal junction showing a thickened muscularis propria, 20x. (B) Congo red stain showing diffuse extracellular positive staining (red-orange) restricted to the muscularis propria, 20x.
CRIONM2015-917157.003.jpg
PMC4637487_01_CRIONM2015-917157.003.jpg
fig3
Autopsy revealed IgG-kappa amyloid deposits in the left and right ventricles (Figure 1), the diaphragm (Figure 2), and the gastroesophageal junction (Figure 3).
Phrenic nerve. (A) Trichrome staining of right phrenic nerve showing preservation of myelin sheath, 400x. (B) Congo red stain of right phrenic nerve, negative for amyloidosis, 400x.
CRIONM2015-917157.004.jpg
PMC4637487_01_CRIONM2015-917157.004.jpg
fig4
There was no demyelination, amyloid deposition, or other abnormalities of the phrenic nerves (Figure 4), nor was there amyloid infiltration of the lung parenchyma.