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19 August 2021: Articles

Cardiac Amyloidosis Presenting with Pre-Excitation Syndrome, Heart Failure, and Severe Factor X Deficiency as Part of Systemic Amyloid Light-Chain (AL) Amyloidosis – A Fatal Combination

Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Educational Purpose (only if useful for a systematic review or synthesis)

Hussam Almasri A* , Ahmed Almeer D , Samah Awouda E , Omnia Hamid E , Sundus Sardar E , Zubair Anwer A , Feryal Ibrahim B , Dina Soliman E , Yahya Kandathil A , Mohammad Abu-Tineh A , Imad Alabdul Razzak E , Safaa Hasan Alazawi F

DOI: 10.12659/AJCR.933398

Am J Case Rep 2021; 22:e933398

Figure 2. (A) BM aspirate smear (Wright’s stain, 1000×) revealed scattered and clusters of plasma cells, averaged ~20%, morphologically abnormal, substantial number show deep condensed peripheral staining with flame plasma cell-like morphology, many appear granulated (lower right insert) or with immunoglobulin inclusions (Russell bodies, arrowed cell) and a few are binucleated (lower left insert) or have a pleomorphic nucleus. (B) Flow cytometry immunophenotyping on BM aspirate revealed 3% monotypic plasma cells (red population) expressing CD38/CD138 with cytoplasmic lambda light-chain restriction with aberrant CD56 and CD117 expression. Flow cytometry showed <1% residual polytypic plasma cells (blue population).

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923