Clinical pathological feature of early tongue amyloidosis.

Objective: To investigate the clinical pathological feature and diagnostic criteria of tongue amyloidosis (AL).

Methods: During 1992 to 2005, 25 patients pathologically diagnosed as tongue AL in our hospital were reviewed retrospectively, and all of them had no enlarged tongue. Haematoxylin and eosin (HE) and immunohistochemical staining were used to detect the amyloid deposition on the tongue.

Results: Totally 84% (21/25) patients had symptoms of xerostomia and taste-blindness, 44% (11/25) patients complained of activity limitation of tongue. Macroscopic observation showed mucosa pallescence, punctuate hemorrhage, red grain particles, and ulcers on the tongue. HE staining indicated amyloid depositions in basement membrane, muscle cell, vessel wall, and nerve fiber. Immunohistochemical study demonstrated kappa light-chain deposition in 64% (16/25) cases, and lambda light-chain deposition in 36% (9/25) cases. They presented in vessel wall, nerve fiber, and muscle cells.

Conclusion: The biopsy is an important means for the diagnosis of early tongue AL, and the wide variety of amyloid light chain is helpful to differential diagnosis.