Pathological review of cardiac amyloidosis using autopsy cases in a single Japanese institution

Yuki Tateishi, Yuichi Yamada, Masato Katsuki, Takuya Nagata, Hidetaka Yamamoto, Kenichi Kohashi, Yutaka Koga, Mikiko Hashisako, Daisuke Kiyozawa, Taro Mori, Yusuke Kuboyama, Ayumi Kakinokizono, Yoshiko Miyazaki, Aina Yamaguchi, Hiroyuki Tsutsui, Toshiharu Ninomiya, Hironobu Naiki, Yoshinao Oda

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: Amyloidosis is a systemic or localized disease of protein deposition characterized by amorphous eosinophilic morphology and positivity of Congo Red staining. The typing of amyloidosis is becoming increasingly important because therapeutic agents for each amyloidosis type have been developed. Herein, the authors review the autopsy cases at an institution to reveal the putative Japanese characteristics of each amyloidosis type and evaluate the clinicopathological significance of each type. Materials and methods: A total of 131 autopsy cases of systemic and localized amyloidosis were retrieved for classification by immunohistochemistry. Immunohistochemistry for transthyretin, amyloid A (AA), immunoglobulin light-chain kappa and lambda, and β2-microglobulin was performed for all cases. Results: The 131 amyloidosis cases were classified as follows: 71 cases (54.2%) of transthyretin amyloidosis, 32 cases (24.4%) of AA amyloidosis, 8 cases (6.1%) of light-chain amyloidosis, and 5 cases (3.8%) of β2-microglobulin amyloidosis, along with 15 equivocal cases (11.5%). All cases showed myocardial involvement of amyloidosis. Histopathologically, the transthyretin type was significantly associated with the interstitial and nodular patterns, and with the absence of the perivascular and endocardial patterns. The AA type was significantly associated with the perivascular and endocardial patterns, and with the absence of the nodular pattern. Conclusion: The authors revealed the putative characteristics of cardiac amyloidosis in Japan by using autopsy cases. About 90% of amyloidosis cases were successfully classified using only commercially available antibodies.

Original languageEnglish
Article number153635
JournalPathology Research and Practice
Volume227
DOIs
Publication statusPublished - Nov 2021

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Cell Biology

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