#10 – Amyloidosis
This 91-year-old female had a history of hypertension, type II diabetes mellitus, congestive heart failure and atrial fibrillation. She was found unresponsive by the staff of the nursing home in which she resided, and was brought to CPMC by EMS. Resuscitation attempts were unsuccessful.
The myocardium in this section is widely infiltrated by an amorphous, pink extracellular material (amyloid). Broad fields and aggregates of amyloid separate myocytes, in some instances extremely widely. In contrast to fibrous tissue (scar) note that there are no cell nuclei within the amorphous protein aggregates, and the amyloid is not well resolved microscopically into fibrils or filaments (this would be seen on transmission electron microscopy).
- amyloid in the interstitial spaces
- myocytes
Amyloid is an an abnormal extracellular protein found in several diseases. The constituent proteins of amyloid are broadly divided into the AL (amyloid light chain) and AA (amyloid –associated, chronic inflammatory) types, although other subtypes containing transthyretin and beta-amyloid (in Alzheimer’s disease cerebral plaques) are described. Demonstrate to your instructor /select a field for annotation and label a region of amyloid protein. Describe one major consequence of amyloid deposition in the heart