Korean J Gastroenterol.  2016 Jul;68(1):49-53. 10.4166/kjg.2016.68.1.49.

A Case of Amyloidosis Presenting as Chronic Cholecystitis, Misdiagnosed as Polymyalgia Rheumatica

• Um YJ
• Kim HA
• Jung JH
• Cho H
• Kang JK

• KMID: 2344493
• DOI: http://doi.org/10.4166/kjg.2016.68.1.49

Abstract

Amyloidosis is a rare disease defined by extracellular deposits of amorphous fibrillar proteins, derived from aggregations of misfolded proteins. Localization of amyloidosis in the gallbladder is uncommon; only eight cases have been reported. We describe a case of amyloidosis diagnosed by cholecystectomy, which possibly also affected the liver and kidney. The patient was misdiagnosed with polymyalgia rheumatica, but after a cholecystectomy to treat chronic cholecystitis, we ultimately diagnosed him with amyloidosis. We review amyloidosis with gallbladder involvement in the literature.

Keyword

Amyloidosis; Gallbladder; Cholecystitis

MeSH Terms

Amyloidosis*
Cholecystectomy
Cholecystitis*
Gallbladder
Humans
Kidney
Liver
Polymyalgia Rheumatica*
Rare Diseases

Figure

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  Fig. 1. Chest CT showed gallbladder (GB) wall thickening at the fundus, suggesting chronic cholecystitis, GB cancer, or adenomyomatosis.

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  Fig. 2. Abdominal ultrasound showed diffuse mild gallbladder (GB) wall thickening, suggesting chronic cholecystitis with no definite visible mass in the GB.

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  Fig. 3. (A) Postoperative H&E staining of the gallbladder showed chronic cholecystitis with amorphous eosinophilic depositions in the lamina propria mucosa (×40). (B) In Congo red staining of the gallbladder, amyloid depositions were stained in the lamina propria mucosa (×40).

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  Fig. 4. Apple-green birefringence was demonstrated in polarized light microscopy of Congo red staining (×40).

Reference

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