Primary amyloidosis. Review of the literature and report of a case

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A brief review of the literature on primary amyloidosis has been presented, and a recent case with oral involvement has been reported. The oral involvement seen in this case was most striking in that the patient's only impetus to seek medical attention was the result of abnormal oral symptoms. Several of the classic oral findings were present; these included macroglossia, decreased mobility of the tongue, and defective speech. All of these abnormalities can be attributed to amyloid deposits in the tongue and associated structures. The submucosal masses of amyloid were reflected clinically as pale yellow hyperkeratotic excrescences, especially in the cheek and lip areas. In addition to the oral findings, evidence of amyloid deposits was noted on the skin in such areas as the nose, anus, and genitals. Microscopic study of the tissues submitted for examination showed the amyloid to be confined to the submucosal areas, with no extensions into the epithelial layers. Muscle tissue in many areas was totally or partially replaced by deposits of amyloid, in which were embedded residual muscle striations and nuclei. This case serves as an excellent example of a systemic condition with oral manifestations. Because of the high frequency of oral involvement, the dentist is in a unique position for the early detection of some cases of amyloidosis. He should, therefore, include this condition in the differential diagnosis when the previously mentioned signs and symptoms are prevalent. © 1968.

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