Hepatic Amyloid Light-Chain Amyloidosis Incidentally Diagnosed via Endoscopic Ultrasound-Guided Liver Biopsy

Hepatic amyloid light-chain (AL) amyloidosis is characterized by amyloid protein deposition in the liver, requiring biopsy for diagnosis. We report a 71-year-old man with lymphoplasmacytic lymphoma/Waldenström macroglobulinemia presenting with hepatomegaly and elevated enzymes. Imaging revealed no masses. The patient was diagnosed with hepatic AL amyloidosis through repeat endoscopic ultrasound-guided liver biopsy (EUS-LB), following an initial inconclusive result. A postprocedural hepatic hematoma resolved within 2 months. To the best of our knowledge, cases of hepatic AL amyloidosis diagnosed through EUS-LB are scarce. This case illustrates the diagnostic utility of EUS-LB in hepatic AL amyloidosis and highlights the need for careful interpretation of postprocedural findings.