PMC5992335_01
Photograph of the patient's face demonstrates (A) periorbital purpura and (B) macroglossia.
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F1
She was found to have periorbital purpura, macroglossia, and hematochezia (Figure 1).
(A) Gastroduodenal artery (GDA) angiography showing 2 focal areas of opacification (arrow) consistent with sites of bleeding. Multiple coils were deployed into the distal GDA. (B) Repeat angiography after coil deployment showed no filling in the GDA and the vessels supplying the clips.
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F2
Repeat angiography showed no filling in the GDA or the vessels supplying the clips (Figure 2).
Microscopic images of the sessile polyp in gastric antrum showing (A) salmon-pink amyloid protein with Congo red stain and (B) apple-green birefringence under polarized light in the submucosal layer (arrows).
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F3
Congo red stain demonstrated salmon pink color with apple-green birefringence under polarized light, which is consistent with amyloid (Figure 3).
Endoscopy 4 weeks after initial treatment showing a 7-mm bleeding sessile polyp in the duodenal bulb.
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F4
Endoscopy revealed a 2-cm bleeding sessile polyp in the gastric antrum and a 7-mm bleeding sessile polyp in the duodenal bulb (Figure 4).