PMC7154250_01
Photograph showing the swelling of the left lacrimal gland (white arrow).
cop-0011-0100-g01.jpg
PMC7154250_01_cop-0011-0100-g01.jpg
F1
Swelling of the lacrimal gland was observed in June 2018, and the patient was referred to our hospital for detailed examination (Fig. 1).
Pathological examination and tissue immunostaining of the left lacrimal gland biopsy showing (a original magnification x10, b original magnification x40) extensive deposition of nonstructural eosinophilic material in the secretory gland and ducts (c original magnification x10, d original magnification x40), which was direct fast scarlet (DFS) positive (e original magnification x40), amyloid A negative (f original magnification x10, g original magnification x40), globulin light chain (kappa) positive (h original magnification x10, i original magnification x40), and globulin light chain (lambda) positive.
cop-0011-0100-g02.jpg
PMC7154250_01_cop-0011-0100-g02.jpg
F2
Immunostaining was negative for amyloid A and positive for globulin light chains (kappa and lambda) (Fig. 2).
Tissue immunostaining of the biopsy specimen of the left lacrimal gland showing transthyretin positivity (a original magnification x10, b original magnification x40).
cop-0011-0100-g03.jpg
PMC7154250_01_cop-0011-0100-g03.jpg
F3
However, additional immunostaining revealed transthyretin positivity (Fig. 3).