Figures & data
Figure 1. Localized AL amyloidosis in a breast. The localized nature and occurrence of microcalcifications (arrows) constitute a risk of misdiagnosis of mammary carcinoma.
Figure 2. Typical appearance of localized AL amyloidosis with discrete amyloid formation and multiple giant cells. Note the concentric appearance of some amyloid particles (arrows).
Figure 3. ‘Amyloidoma' immunolabeled with the immunoglobulin light chain lambda-specific monoclonal antibody pwlam (Citation73). Amyloid and a majority of plasma cells (PC) are strongly labeled. Note the giant cells (GC) between plasma cells and amyloid. The hypothesis is that plasma cells are synthesizing an amyloidogenic Ig light chain, which is modified by giant cells to amyloid fibrils.
Figure 4. Amyloid adjacent to giant cells (GC). An organization of amyloid fibrils is apparent when in contact with giant cells. This organization is interpreted as assemblage of protein, probably after some modification, into fibrils on or at the surface of the cells. Congo red stained section in polarized light with crossed polars.
Figure 5. Suggested events in localized AL amyloidosis. A plasma cell clone develops at one site. The cells express amyloidogenic Ig light chains and, in addition, an unknown factor that attracts macrophages and cause them to fuse into giant cells. Ig light chains are modified by giant cells and aggregate into bundles of amyloid fibrils at the surface of these cells. In addition, smaller aggregates of Ig light chains are toxic to plasma cells, an event controlling the plasma cell clone.
