Localized intestinal AL amyloidosis detected as bright green using autofluorescence endoscopy

Masatake Kuroha, Tsuneaki Yoshinaga, Masahide Yazaki, Fumiyoshi Fujishima, Tomoyuki Handa, Kaoru Suzuki, Kasumi Hishinuma, Yutaro Masu, Yusuke Shimoyama, Takeo Naito, Rintaro Moroi, Yoshitake Kanazawa, Hisashi Shiga, Yoichi Kakuta, Atsushi Masamune

Research output: Contribution to journalArticlepeer-review


Amyloidosis is classifiable as systemic, with amyloid deposition in organs throughout the body, or localized, involving only one organ. Amyloidosis localized in the intestinal tract is rare. This report describes three cases of localized AL amyloidosis in the intestinal tract and presents their clinical characteristics, endoscopic findings, and prognoses. All three cases were asymptomatic, and were found accidentally during endoscopy for closer examination after a positive fecal occult blood test. Endoscopic findings included patchy redness and meandering dilated vessels of the lesion. Using autofluorescence (AFI) endoscopy, the lesion of amyloid deposition was enhanced as bright green. We used fluorescence microscopy to observe unstained specimens obtained from an amyloid deposition site with excitation light. Autofluorescence was detected with the broad excitation wavelength at amyloid deposition lesion sites of the specimen. Results revealed that AL amyloid has autofluorescence that engenders its detection by AFI endoscopy as bright green. In none of the three cases was systemic amyloidosis or organ failure observed. The long-term course of all the cases was favorable.

Original languageEnglish
Pages (from-to)815-819
Number of pages5
JournalClinical Journal of Gastroenterology
Issue number3
Publication statusPublished - 2021 Jun


  • AA amyloidosis
  • AFI
  • AL-λ amyloid
  • Fluorescence microscope
  • Systematic amyloidosis


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