Nagai Toshiya, Yunoki Tatsuya, Hayashi Atsushi
Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.
Case Rep Ophthalmol. 2020 Mar 6;11(1):100-105. doi: 10.1159/000505480. eCollection 2020 Jan-Apr.
Localized amyloidosis of the lacrimal gland is a rare disease. We report a case of transthyretin-positive localized amyloidosis of the lacrimal gland in a 74-year-old man with left lacrimal gland swelling. Biopsy of the left lacrimal gland showed extensive deposition of nonstructural eosinophilic material in the secretory gland and ducts, which stained positive with direct fast scarlet. Immunostaining was negative for amyloid A and positive for both globulin light chain (kappa, lambda) and transthyretin. It is necessary to consider the possibility of senile systemic amyloidosis, even if localized amyloidosis of the lacrimal gland is suspected.
泪腺局限性淀粉样变性是一种罕见疾病。我们报告一例74岁男性左泪腺肿胀患者，其泪腺为转甲状腺素蛋白阳性的局限性淀粉样变性。左泪腺活检显示分泌腺和导管中有大量无结构嗜酸性物质沉积，直接耐晒猩红染色呈阳性。免疫染色显示淀粉样蛋白A阴性，球蛋白轻链（κ、λ）和转甲状腺素蛋白均为阳性。即使怀疑是泪腺局限性淀粉样变性，也有必要考虑老年性系统性淀粉样变性的可能性。
