Beyer D, Krug B, Stelzner M
Rofo. 1986 Nov;145(5):551-5. doi: 10.1055/s-2008-1048987.
The diagnostic radiologist may have problems with the differential diagnosis of gastrointestinal amyloidosis combined with only uncharacteristic clinical symptoms. In the stomach upper gastrointestinal series show in most cases stenosing submucosal masses in the gastric antrum with diminished peristalsis and pliability. Sonography reveals a circular thickening of the gastric antrum wall. Only a synopsis of radiologic changes, the patients's history, laboratory tests and biopsies render a clue to the correct diagnosis. In the small bowel segmental or total intestinal dilatation with sonographically demonstrable thickening of the bowel wall and diminished motility, prolonged transit and eventually obstruction or paralytic ileus can be demonstrated. In patients with simultaneous plasmocytoma the radiologist has to take a gastrointestinal involvement by concurrent amyloidosis into account.
诊断放射科医生在鉴别诊断仅伴有不典型临床症状的胃肠道淀粉样变性时可能会遇到问题。在胃部,上消化道造影在大多数情况下显示胃窦部有狭窄的黏膜下肿块,蠕动和柔韧性减弱。超声检查显示胃窦壁呈环形增厚。只有综合放射学改变、患者病史、实验室检查和活检结果才能为正确诊断提供线索。在小肠,可显示节段性或全肠道扩张,超声检查可证实肠壁增厚且蠕动减弱、传输时间延长,最终可出现梗阻或麻痹性肠梗阻。对于同时患有浆细胞瘤的患者,放射科医生必须考虑到并发淀粉样变性累及胃肠道的情况。