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Congo is the answer
Sara Santos, Manuel Rocha, Guilherme Simões, Verónica Gamelas, Rita Saraiva, Jorge Esteves
Centro Hospitalar Universitário de Lisboa Central
A 65 year-old male with no relevant medical history was admitted to the emergency with complaints of asthenia and dark-colored vomiting. Microcitic anemia was present and upper endoscopy showed a diffusely edematous and irregular mucosa, with multiple fine neovascularization and marked friability. Histology revealed extensive deposits of amyloid material, with positive staining for Congo red, and presence of lambda light chains. Further investigation was negative for systemic amyloidosis or hematological disease, confirming the diagnosis of AL type amyloidosis, located in the stomach. The patient remained closely monitored, medicated with PPI, with resolution of anemia, maintaining the endoscopic and histologic features.
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