Amyloidosis: a Case Report Involving Oral Structures

Abstract

We report a case of systemic amyloidosis, diagnosed based on oral manifestations. A 72-year-old woman was admitted to the stomatology department due to difficulty in swallowing and tongue movement. A clinical examination revealed a fibrous consistency of the tongue with severe limitation of movement, impression of lingual surfaces of the lower teeth, and hyposalivation. Furthermore, the orbicularis muscles, submandibular glands, and neck lymph nodes showed fibrous hardening. A tongue and lip biopsy were performed, and on microscopic investigation, deposition of amorphous eosinophilic extracellular material was observed. The use of Congo red staining under polarized light revealed green apple birefringence. Clinical and pathological correlations confirmed the diagnosis of systemic amyloidosis. The patient was treated with chemotherapy and autogenous bone marrow transplantation. Despite a period of significant improvement, the patient died after 4 years. Although rare, amyloidosis may affect the mouth and can be first noticed by its oral symptoms.