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Summary
This study details a rare case of primary A-lambda-light chain amyloidosis presenting as macroglossia, leading to a multiple myeloma diagnosis. It highlights macroglossia as a potential primary indicator of this serious condition.
Area of Science:
- Oncology
- Hematology
- Pathology
Background:
- Amyloidosis encompasses diverse disorders characterized by amyloid protein deposition in tissues.
- Presentations vary, including senile, familial, systemic, localized, secondary, and primary forms.
Observation:
- A 79-year-old woman presented with macroglossia (enlarged tongue) due to amyloid deposits in the tongue and floor of the mouth.
- This presentation was identified as primary A-lambda-light chain amyloidosis.
Findings:
- Further investigations revealed the underlying cause to be multiple myeloma, staged as IIa by Durie and Salmon criteria.
- While macroglossia secondary to multiple myeloma is documented, its occurrence as a primary diagnostic finding is exceptionally rare.
Implications:
- This case underscores the importance of considering macroglossia as a potential initial clinical manifestation of multiple myeloma.
- It suggests that early recognition of amyloidosis-related macroglossia can facilitate timely diagnosis and management of underlying plasma cell dyscrasias.