Systemic amyloidosis and non-hematologic malignancy in a large autopsy series

A series of 24,388 consecutive autopsies yielded 148 cases of amyloidosis, for which the associated diseases were tabulated. 13 solid primary malignancies were found in eleven patients, including one mucoepidermoid cancer of the parotid and one thymoma; two out of eleven had evidence of pyelonephritis. Five patients suffered from past or present renal adenocarcinoma, the most common carcinomatous cause of amyloidosis. Systemic amyloid deposits thus occurred in 2.1% of autopsied patients with renal carcinoma, but showed no obvious correlation with tumor stage or histologic type. Details are presented of an unusual case of hypernephroma producing a stable bronchial metastasis cuffed by nodular amyloid and dissociated by a lymphoid infiltrate containing plasma cells. The occurrence of systemic amyloidosis in non-hematologic malignancy thus appears to be a rare event, which, especially in the case of renal cancer, is assumed to be due to amyloid-fibril protein AA.