Spheroid-type of AL amyloid deposition associated with colonic adenocarcinoma: A case report with literature review

Moon Joo Kim, Zulfia McCroskey, Yingchao Piao, Anna Belcheva, Luan Truong, Paul J. Kurtin, Jae Y. Ro

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


We report a colonic adenocarcinoma associated with diffuse submucosal deposition of a peculiar spheroid-type amyloid identified in the colon, terminal ileum, and appendix. A 65-year-old woman with past medical histories of hypertension, and chronic obstructive pulmonary disease, presented to the emergency room with cramping abdominal pain and nausea. A computed tomography (CT) scan of abdomen showed right colonic volvulus. Emergency right hemicolectomy was performed. The specimen showed colonic adenocarcinoma with focal submucosal invasion (pT1) arising from a villotubular adenoma. A diffuse submucosal spheroid-type amyloid deposition (resembling corpora amylacea-like structures with Liesegang ring formation) was identified in the colon, ileum, and appendix. Electron microscopy examination of this unusual spheroidal-type material further confirmed the presence of amyloid fibrils. Analysis by liquid chromatography–mass spectrometry detected AL (lambda) type amyloidosis in this specimen. Tests for monoclonal gammopathy were not performed because patient consent was not obtained. In tissue section evaluation, however, no plasma cell neoplasm was identified. Cases with isolated AL amyloid deposition in the gastrointestinal tract have been reported rarely, and there is no case report of colonic adenocarcinoma associated with primary amyloid deposition in the English literature.

Original languageEnglish (US)
Pages (from-to)123-127
Number of pages5
JournalPathology International
Issue number2
StatePublished - Feb 2018


  • Liesegang rings
  • colonic adenocarcinoma
  • electron microscope
  • spheroid-type amyloid

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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