Amyloid deposition in the tongue: clinical and histopathological profile

Oral amyloidosis is a rare and debilitating disease that, whether primary or secondary, may severely impact the quality of a patient's life. The study investigated the characteristics of amyloid deposition in the tongue from the clinical and histopathological profiles.

Biopsy specimens were received from five patients: 2 female, 3 male. All biopsies were taken from the tongue, and all had amyloid deposition in the subepithelial connective tissue, conclusive for a diagnosis of amyloidosis. All patients showed macroglossia and difficulty in eating and impairment of speech.

In three cases there was no evidence of systemic involvement or associated disease; these were characterized as localized amyloidosis of the tongue. The other two cases revealed multisystemic involvement. Histologically, the disease was diagnosed through specific staining with Congo red, which examined under polarized light revealed the amyloid deposits as apple-green birefringence.

The findings show the tongue to be the site most frequently affected in forms of localised amyloidosis, and that a tongue biopsy possess a highly diagnostic value for amyloidosis. There is still no consensus regarding the management of lingual amyloidosis, although numerous therapies have been proposed, including surgical excision and pharmacological treatment. However lesions often persist or recur. The prognosis is uncertain, owing to the rarity of the condition, requiring regular follow-up and monitoring.