Enlarged tongue due to Primary Systemic Amyloidosis:Clinipathology observation of the tongue

Objectives:We describe two patients with enlarged tongue due to primary system amyloidosis (AL).Methods:In the first case the patient had grain lesion s of grayish-red in color and lingual nodules recurring punctuate hemorrhage on the back of the tongue, and complained of xerostomia and dysphasia difficulty. In the second case early manifestation of the tongue lesions was characteristically pale in color ,dry,a glossy surface and firm in consistency, taste-blindness had occurred. The resulting difficulty in tongue mobility and chewing stimulated the patient to seek advice. There is an enlarged tongue of varying degrees in each case. The tongue biopsy demonstrated numerous amyloid depositions of amorphous material. Immunohistochemical staining of kappa or lambda light chain were applied for AL typing. Results:Tongue specimens showed subepithelium, muscle layer, vascular wall and nerve fibrils staining of linear. When a case of gradual enlargement of the tongue in an adult is diagnosed. Dentists should be aware that AL be included in the differential diagnosis. Amyloid deposits in the tongue may be localized or generalized .Conclusions:These findings suggested staining of lingual tissue-immunoglobulin light chain is important for diagnosis of primary systemic AL in early stage.