Abstract
A 79-year-old female patient was monitored under hospital care by the multidisciplinary team because of severe oropharyngeal dysphagia with a 3-year evolution. Clinical examination revealed a medical history of systemic arterial hypertension, left ventricle diastolic dysfunction, hypothyroidism, and bilateral carpal tunnel syndrome. In view of the clinical picture presented, amyloidosis was the main diagnostic hypothesis. During intraoral examination the hospital dental team's evaluation revealed macroglossia, crenated tongue and lingual varicosities, saliva accumulation in the oral cavity, and vestibularized anteroinferior teeth. Therefore, an incisional biopsy was performed in the tongue dorsum region and in the intraoral lower lip mucosa (minor salivary gland). After the anatomopathologic examination with a special Congo red stain, amyloidosis was diagnosed. With the diagnostic definition, the patient proceeded with specific medical treatment and speech therapy.
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