PMC4527044_01
Computed tomography image of abdominal wall lesion. Sections were taken at 5 mm intervals. Image 31 of series #2 shows greatest dimensions of lesion as well as its homogenous nature
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F1
CT scan showed a 5 cm x 1.6 cm homogenous mass [Figure 1].
Fine-needle aspiration smears of amyloid, Diff Quik stain. (a) Smear shows abundant deep blue/purple colored amorphous material (x20). (b) On high power, this material resembles has tissue paper appearance, resembling keratin debris (x40)
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F2
Smears contained abundant material and showed small and large aggregates of thick orangeophilic material with a flaky texture on Papanicolaou stain and fluffy magenta colored acellular material on Diff Quik stain [Figures 2 and 3].
Fine-needle aspiration smears of amyloid, Papanicolaou stain. (a) Orangophilic waxy material is abundant on this smear. Smaller globules in the lower left corner mimic anucleated squamous cells (x20). (b) High power demonstrates dense waxy appearance of amyloid; a few spindled cells are seen intermixed with amyloid (x40)
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F3
Smears contained abundant material and showed small and large aggregates of thick orangeophilic material with a flaky texture on Papanicolaou stain and fluffy magenta colored acellular material on Diff Quik stain [Figures 2 and 3].
Core biopsy. (a) This core biopsy slide shows amorphous eosinophilic dense material (H and E, x20). (b) The material is homogeneous and red with Congo stain (Congo, x20). (c) The core biopsy shows apple green/yellow birefringence (Congo, under polarized light, x40)
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F4
Core biopsy showed fragments of a cellular pink waxy material and hyalinized tissue [Figure 4a]. Congo red stain was positive; green birefringence was seen under polarized light [Figure 4b].