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We present the case of a white male patient, 63 years of age, with no relevant medical history, with different lingual nodules for the past 3 months and asymptomatic clinical condition. The intraoral examination showed the existence of 2 nodules located exclusively on the lingual dorsal aspect at the anterior third, with the right showing an irregular form (white arrows) with a size of 3<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cm, and the left being well delimited and measuring 1<span class="elsevierStyleHsp" style=""></span>cm in diameter (black arrow) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Clinical palpation showed a painless indurated texture with no changes in colour, non-pulsatile character, absence of macroglossia and integrity of the rest of the lingual mucosa. The rest of the intraoral examination performed with fibreoptic bronchoscopy did not show significant findings. A biopsy was performed (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) showing an extensive deposition of glomerular-looking amyloid infiltrate (white arrow) after Congo red staining. Apple-green birefringence under polarized light was seen after staining with thioflavin (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). As it was an isolated involvement or LA it corresponded to a deposit of lambda light chain immunoglobulin produced by the plasma cells, despite the fact that the complementary tests performed had ruled out the existence of systemic involvement and associated diseases (plasma cell dyscrasias). The differential diagnosis should be made with other entities such as fibroids, sarcomas, lipomas, salivary gland tumours, vascular malformations and Abrikossoff tumour. Given its isolated and painless clinical involvement, a waiting attitude is advised, together with long-term clinical follow-up.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sánchez López JD, Rodríguez Ruiz JA, Martínez-Sahuquillo Rico A. Amiloidosis nodular lingual aislada. Med Clin (Barc). 2020;154:424.</p>" ] ] "multimedia" => array:3 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 778 "Ancho" => 583 "Tamanyo" => 57368 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 985 "Ancho" => 1650 "Tamanyo" => 394422 ] ] ] 2 => array:6 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 743 "Ancho" => 1500 "Tamanyo" => 70634 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015400000010/v1_202005290855/S238702062030142X/v1_202005290855/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015400000010/v1_202005290855/S238702062030142X/v1_202005290855/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S238702062030142X?idApp=UINPBA00004N" ]
Journal Information
Vol. 154. Issue 10.
Pages 424 (May 2020)
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Vol. 154. Issue 10.
Pages 424 (May 2020)
Image in medicine
Isolated lingual nodular amyloidosis
Amiloidosis nodular lingual aislada
José Darío Sánchez López
, Juan Andrés Rodríguez Ruiz, Angel Martínez-Sahuquillo Rico
Corresponding author
Servicio de Cirugía Oral y Maxilofacial, Hospital Universitario Virgen de las Nieves, Granada, Spain
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