Immunohistologic classification of systemic amyloidosis by fat aspiration biopsy

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Abstract
Amyloidosis in the modern era is a spectrum of disease caused by an ever-increasing number of chemically different fibrillar proteins that accumulate in tissues. The different amyloid types can be distinguished by immuno-histochemical examination of involved tissues. We describe the use of immunofluorescence and immunoelectron microscopy to determine the chemical type of amyloid in 16 fat aspirates from 16 patients with amyloid deposits in their abdominal fat. The amyloid in 12 specimens was classified as lambda light chain type and in 3 as kappa light chain. Only one aspirate could not be im-munohistochemically classified. Corroborative data included a corresponding monoclonal Ig in the serum or urine in 15 of 16 patients, a corresponding restricted clonality of bone marrow cells in 10 of 11 patients, and the detection of the same light chain isotype in other tissues with amyloid in 8 of the patients. Fat aspiration biopsy is a rapid, safe and cost-effective method for diagnosis and classification of the chemical type of amyloid.

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