Gastrointestinal amyloidosis is relatively common, although symptomatic involvement is more rare. It is diagnosed if there are persistent gastrointestinal (GI) symptoms with endoscopic biopsy proven amyloid deposition.
On this page:
Epidemiology
Tends to affect middle-aged and older patients.
Clinical presentation
Weight loss (most common) and GI bleeding are the main symptoms. Other symptoms include gastro-esophageal reflux, constipation, nausea, diarrhea, weight loss, early satiety, and abdominal pain.
Pathology
Bowel changes result from amyloid infiltration of the muscularis and destruction of Auerbach plexus.
Location
- duodenum (most common)
- stomach (second most common): the gastric manifestations of amyloidosis include gastric fold and or wall thickening and rigidity. Luminal narrowing can cause a linitis plastica type appearance and mimic gastric carcinoma.
- colon and rectum
- esophagus
Radiographic features
Radiological findings are rare and non-specific, unlike the pathologic high specificity.
Fluoroscopy
On fluoroscopy, the gastric mucosa may display thickened folds, which may appear nodular or mass-like and which may contain calcifications.
CT
Features include:
- diffuse wall thickening of the involved segment of bowel
- intussusception
- dilatation depending upon the degree of hypomotility; GI bleeding can also cause dilated bowel loops with fluid levels
- luminal narrowing either due to amyloid infiltration or secondary to ischemia
Differential diagnosis
- infectious enteritis (e.g. Shigella, Salmonella, Escherichia coli, cytomegalovirus, Cryptococcus, pseudomembranous colitis, AIDS)
- bowel ischemia
- other infiltrating processes, e.g. small bowel lymphoma
- other causes of GI bleeding
Unable to process the form. Check for errors and try again.