DIAGNOSTIC INSIGHTS FROM BONE MARROW BIOPSY IN PRIMARY AMYLOIDOSIS: A CASE REPORT

Amyloidosis encompasses a group of clinical disorders characterized by the abnormal accumulation of misfolded proteins in various organs1. These amyloid deposits can be localized or systemic, with systemic amyloidosis most commonly presenting as the AL type in approximately 75% of cases2. This subtype results from amyloidogenic immunoglobulin light chains produced by plasma cells in the bone marrow. The extent of plasma cell infiltration within the bone marrow varies among patients. Studies indicate that amyloid deposits are identified in about 60% of bone marrow core biopsy specimens, with a predominant presence in blood vessel wall. However, when interstitial amyloid deposition occurs, it is more frequently linked to monoclonal κ light chain gammopathy. Bone marrow core biopsy, utilizing standard histochemical and immunohistochemical staining, plays a crucial role in diagnosing AL amyloidosis by evaluating plasma cell dyscrasia and determining the specific clonal light chain type2. Given that the bone marrow is central to plasma cell dyscrasia and light chain production, biopsy findings are essential for assessing disease extent. In this report, we present a case of primary amyloidosis that initially manifested with liver involvement and was subsequently confirmed through the identification of amyloid deposits in the bone marrow biopsy.