Amyloid in prostatic corpora amylacea.

AIM: To determine the presence and nature of amyloid in prostatic corpora amylacea using immunohistological studies. METHODS: Prostatic tissue from 18 transurethral and two open resection specimens was studied. Paraffin wax embedded tissue sections were stained with haematoxylin and eosin and the alkaline Congo red method with and without previous treatment with potassium permanganate. Sections were also stained with antibodies to amyloid A, beta 2 microglobulin, lambda and kappa light chains, prealbumin IgA, G, M, S100 protein, prostatic specific antigen, amyloid P component and CAM 5.2 (control and blocking studies were performed). RESULTS: The prostatic corpora amylacea universally showed the presence of amyloid. In all instances this contained beta 2 microglobulin. CONCLUSION: Prostatic corpora amylacea represents a localised amyloidosis of beta 2 microglobulin origin that is unrelated to chronic renal failure and haemodialysis.

Systemic amyloidosis of beta 2 microglobulin type.

A patient receiving haemodialysis for 15 years developed systemic amyloidosis of beta 2 microglobulin type. Noticeable deposits of amyloid were present in the myocardium, intervertebral discs, joint cartilages and tendons. Less conspicuous amounts were present in blood vessel walls in the lungs, liver, adrenal glands and brain, and within the stroma of the prostate, testis and kidney, often with foci of calcification.

[Beta 2-microglobulin amyloidosis]. / Amyloidóza beta 2-mikroglobulinového typu.

A 35-year-old man who had been treated by hemodialysis for 15 years suffered from systemic amyloidosis. It was identified as a beta 2-microglobulin type according to immunohistochemistry. Extensive amyloid deposits were found in myocardium, cartilages of intervertebral discs and in carpal tunnel ligament. Less conspicuous deposits comprised blood vessels of lungs, liver, suprarenal glands, brain, and stroma of prostate gland, testicles, kidney, often combined with calcified foci.

Carpal tunnel syndrome caused by amyloid containing beta 2 microglobulin: a new amyloid and a complication of long term haemodialysis.

Three patients receiving long term haemodialysis treatment for chronic renal failure due to non-amyloid nephropathy developed the carpal tunnel syndrome requiring decompression surgery. The excised material contained amyloid, which by immunocytochemical techniques was shown to contain beta 2 microglobulin. This is, therefore, a new chemical form of amyloid whose deposition is likely to be the cause of osteoarticular and connective tissue disorders, which are being recognised with increasing frequency in patients receiving long term haemodialysis. Raised beta 2 microglobulin levels are known to occur in chronic renal failure, and the molecule is unable to cross conventional dialysis membranes. The importance of beta 2 microglobulin amyloidosis lies in the threat which it poses to the success of long term haemodialysis.