Interesting Case of the Month - (IGHP, ICOM) - October
october
Clinical History-
40-year-old male was admitted with complaints of jaundice associated with weakness and abdominal discomfort. Lab investigations showed LFT Bilirubin-6.7mg/dl, SGOT/ SGPT-124/ 73 U/L, SAP/ GGT-471/ 234 U/L. LDH-168 U/L. Total protein-7.0 g/dl, Albumin-2.2 g/dl, Globulin-4.8 g/dl. CBC-Hemoglobin -10.3 g/dl, ESR-63. Scrub typhus positive. ALIP Negative, ceruloplasmin 42.6, raised TLC 15.7. USG guided liver biopsy was taken.
Radiology-
MRI show grossly enlarged liver measuring 27cm and show coarse enhancement pattern-
Microscopic Images-
Special Stains Performed-
Immunohistochemistry-
Immunohistochemistry performed for Kappa, Lambda and Serum Amyloid Associated Protein. The acellular material is Lambda positive and negative for Kappa and SAA IHC.
A. Primary amyloidosis, Kappa Restricted-
B. Primary amyloidosis, Lambda Restricted
C. Secondary Amyloidosis
D. Metastatic Carcinoma-
