Changes of the gastrointestinal mucosa in 4 cases of systemic amyloidosis

We detected amyloid in the alimentary tract of four cases from July, 1990 to October, 2005. Mucosal changes such as redness, erosion, ulcer, or bleeding were seen in these cases, although amyloid was detected even from normal mucosa. Typical endoscopic features of massive amyloid deposition in AA amyloidosis was a fine granular appearance or an oedema-like mucosa, while that in AL amyloidosis was multiple polypoid protrusions or a thickening of the mucosal fold. However, the amyloid deposition in many cases was not extensive and the mucosal changes were slight. We conclude that, in order to diagnose amyloidosis at early stage, an endoscopic biopsy should be performed when a slight mucosal change or even normal mucosa, such as our cases, is observed.