Systemic amyloidosis terminating in cardiac insufficiency.

An autopsy case of systemic amyloidosis is presented. The patient, a 57-year-old male, died of congestive heart failure. Autopsy revealed systemic amyloidosis which involved the heart, liver, spleen, kidneys, lymph nodes, tongue, prostate, rectum, and small blood vessels of various organs. In the heart, amyloid deposited diffusely in the myocardium, subendocardial tissue, and blood vessel walls. A lot of vacuolated cardiac muscle fibers were noted. Electron microscopic examination of the myocardium revealed that amyloid fibrils surrounded most of the cardiac muscle fibers in the very close vicinity of their basement membranes. Fashion of the amyloid deposition throughout various organs and the mechanism of heart failure are discussed.