Diagnosis of amyloidosis

Abstract

The diagnosis of all types of amyloidosis now depends on histological identification of the amyloid material in tissue. In this broadsheet the authors discuss briefly the pathology of amyloidosis, with special reference to biopsy specimens; review the staining methods available; and recommend the best routine stains. It should enable a histopathologist to give a confident opinion on whether amyloid material is present or absent. Reports such as 'suggestive of' or 'probable amyloidosis' should be avoided so far as possible. The pathologist should have sufficient faith in his staining techniques to be dogmatic, although sometimes the amount of amyloid is small. A knowledge of the tissue distribution patterns may also enable the pathologist to offer prognostic advice to his clinical colleagues.