Characteristics of 23 Consecutive Patients with Known or Suspected Amyloidosis and Findings on 99mTc-Aprotinin Scintigraphy
| Patient no. | Sex | Age (y) | Type of amyloidosis/coexisting malignant disease and clinical conditions | 99mTc-Aprotinin accumulations on scintigraphy | Biopsy or autopsy positive or negative* | Symptoms on scintigraphy† | |
|---|---|---|---|---|---|---|---|
| 1 | F | 86 | AL amyloidosis/IgGκ multiple myeloma | Hands | + | ||
| Tongue | + | + | |||||
| Submandibular glands | + | + | |||||
| Heart, intestines | − | ||||||
| 2 | M | 39 | AL amyloidosis renis/nephrotic syndrome, multiple myeloma (κ light-chain disease) | Heart | + | + | |
| Paraaortic lymph nodes | + | − | |||||
| Liver | + | − | |||||
| Spleen | + | − | |||||
| 3 | M | 62 | AL amyloidosis/plasmacytoma with amyloidosis, multiple myeloma (λ light-chain disease) | Left eye region | +‡ | ||
| Upper mediastinum | + | + | |||||
| Left shoulder | + | ||||||
| Liver | − | ||||||
| 4 | M | 59 | AL amyloidosis/IgGκ M component, MGUS | Heart, liver | − | ||
| Spleen | − | ||||||
| —— | + rectum, + bone marrow, + lip | ||||||
| 5 | M | 64 | AL amyloidosis renis/(λ light chain in urine) | Heart | + | − | |
| Right lung/pleura | + | − | |||||
| Liver | + | − | |||||
| Spleen | + | − | |||||
| 6 | F | 78 | AL amyloidosis/initially plasmacytoma, multiple myeloma (κ light-chain disease) | Both pleura/lungs | − | ||
| Left maxillary sinus | + | + | |||||
| Calvarium | + | + | |||||
| Right shoulder | + | − | |||||
| Left femur | − | ||||||
| 7 | F | 66 | AL amyloidosis renis/multiple myeloma IgAλ | Lungs | − | ||
| Liver, intestines | − | ||||||
| 8 | F | 70 | Clinically evident amyloidosis/multiple myeloma (λ light-chain disease) | Liver, spleen | − | ||
| 9 | F | 56 | Localized amyloidosis in plica vocalis/no myeloma | Liver | − | − | |
| — | + plica vocalis | + | |||||
| 10 | F | 66 | Clinically evident amyloidosis/IgAλ multiple myeloma | Heart | +§ | ||
| Tongue | + | ||||||
| Liver | − | ||||||
| 11 | F | 75 | AL amyloidosis renis | Liver | + | + | |
| Spleen | − | ||||||
| 12 | F | 45 | Localized amyloidosis in biopsy of sural nerve | — | + of sural nerve | Polyneuropathy | |
| 13 | M | 55 | AL amyloidosis/IgGκ multiple myeloma | Heart | + | +¶ | |
| 14 | M | 50 | Hereditary amyloidosis | Heart | + | + | |
| Pleura, intestines | − | ||||||
| 15 | M | 73 | AL amyloidosis renis/IgMκ macroglobulinemia Waldenström | Lungs | − | ||
| Liver, spleen | − | ||||||
| Intestines | − | ||||||
| 16 | F | 57 | Hereditary amyloidosis | Heart | + | ||
| Lungs | + | ||||||
| Liver, pleura | − | ||||||
| 17 | F | 60 | Clinically evident amyloidosis/IgGκ multiple myeloma | Lungs | + | ||
| Liver | − | ||||||
| 18 | F | 58 | AL amyloidosis/macroglobulinemia Waldenström, and cold-agglutinin syndrome | Liver | + | ||
| Spleen, intestines, lungs | − | ||||||
| All major joints | + | ||||||
| Metacarpophalangeal regions and fingers | + pathologic fracture of right femur, + bone marrow | + | |||||
| 19 | F | 58 | Localized amyloidosis in bronchial biopsy | Lungs, liver | − | ||
| 20 | M | 54 | AL amyloidosis/IgMκ | Liver | + | + | |
| Spleen | + | − | |||||
| Intestines | + | ||||||
| + heart,‖ + alveolar walls, + vascular walls in lungs, + bone marrow | + | ||||||
| 21 | F | 67 | AL amyloidosis/nephrotic syndrome IgAλ | Liver | + | ||
| Spleen, lungs | − | ||||||
| Shoulders, nasopharynx | − | ||||||
| 22 | M | 53 | AL amyloidosis/multiple myeloma, gastrointestinal and bone marrow amyloid deposits | Tongue | + | ||
| Pleura | − | ||||||
| Liver, spleen | − | ||||||
| 23 | F | 57 | AL amyloidosis of lungs | Lungs | + | + | |
| Liver | − |
↵* Positive (+) or negative in relation to scintigraphic findings.
↵† Positive (+) = symptoms on scintigraphy; negative (−) = no symptoms on scintigraphy.
↵‡ Had scintigraphy performed twice within 6 mo after chemotherapy and autologous transplantation of bone marrow and had clinical, paraclinical, and scintigraphic reduction of tumor size in mediastinum.
↵§ After medical treatment with alkaran and prednisolone, patient had regression of symptoms.
↵¶ Had scintigraphy performed twice within 6 mo after chemotherapy and autologous transplantation of bone marrow with remission of multiple myeloma, but no change in cardiac uptake on scintigraphy or cardiac performance.
↵‖ Cardiac region was not sufficiently covered by scintigraphic study.
MGUS = monoclonal gammopathy of unknown significance.