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La amiloidosis de la vesícula biliar es a menudo inesperada y puede tener implicaciones sistémicas
Catherine E Hagen1, Surendra Dasari2, Jason D Theis1
1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States.
American journal of clinical pathology
|August 29, 2025
Resumen
La amiloidosis de la vesícula biliar es a menudo un diagnóstico inesperado, siendo la vesícula biliar con frecuencia el primer tejido identificado con la enfermedad. Todos los pacientes estudiados mostraron afectación sistémica, lo que pone de relieve la necesidad de una detección y tratamiento tempranos.
Área de la Ciencia:
- Patología
- Diagnóstico médico
- Proteomía
Sus antecedentes:
- La amiloidosis es una enfermedad sistémica caracterizada por la deposición extracelular de proteínas mal plegadas.
- La participación de la vesícula biliar en la amiloidosis no es ampliamente reconocida, lo que podría llevar a retrasos en el diagnóstico.
Objetivo del estudio:
- Para analizar una gran cohorte de casos de amiloidosis de la vesícula biliar.
- Identificar las características clínicas y morfológicas de la amiloidosis de vesícula biliar.
- Para determinar los tipos y la prevalencia de amiloide en la vesícula biliar.
Principales métodos:
- Revisión retrospectiva de 118 muestras de colecistectomía analizadas entre 2008 y 2023.
- Se utilizaron técnicas basadas en la proteómica para la tipificación de amiloides.
- Se evaluaron las características clínicas y morfológicas.
Principales resultados:
- Se identificaron seis tipos de amiloides, siendo las más comunes la amiloidosis transtirretiniana (ATTR) y la amiloidosis de cadena ligera (AL).
- La amiloidosis fue un diagnóstico inesperado en la mitad de los pacientes con información clínica.
- Se observó afectación de vasos perimusculares en todos los casos revisados morfológicamente.
- Todos los pacientes con seguimiento demostraron evidencia de enfermedad sistémica.
Conclusiones:
- La amiloidosis de la vesícula biliar es frecuentemente un hallazgo inesperado y puede ser la presentación inicial de una enfermedad sistémica.
- El examen cuidadoso de las muestras de colecistectomía, en particular de los vasos perimusculares, es crucial.
- La tipificación rápida de amiloide, especialmente en pacientes de edad avanzada, puede prevenir retrasos en el diagnóstico y mejorar el manejo.
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