Case report and review of the literature of primary gastrointestinal amyloidosis diagnosed with enteroscopy and endoscopic ultrasonography

Figure 1 Representative images of enteroscopy at admission. A: Nodular protuberances (arrows) in the esophagus; B: Nodular protuberances (arrows) in the ileum; C: Nodular protuberances (arrows) in the hepatic area of the colon; D: Nodular protuberances (arrows) in the rectum.

Figure 2 Images of endoscopic ultrasonography. A: Nodular protuberances in the esophagus stemming from hypoechoic lesions of the submucosa, and the layer of origin was clear; B: Nodular protuberances in the colon stemming from the submucosa, partially invading the intrinsic myometrium with a hypoechoic structure, which is partially hypoechoic fusion and inhomogeneous echo.

Figure 3 Pathological examination with hematoxylin and eosin staining. A: The central portion of an esophagus biopsy sample containing a homogeneous powder and dyed structure (arrows), which is surrounded by inflammatory cells and fibrous tissues (magnification 10 × 4); B: The biopsy sample of ileum containing multiple homogeneous powder dyeing (arrow) without structural small nodules in the submucosal layer (MAGNIFICATION 10 × 4).

Figure 4 Positive staining of Esophagus biopsy sample. A: With Congo red; B: With Masson blue; C: With Periodic Acid-Schiff.

Figure 5 Representative images of enteroscopy three years after admission. A: Nodular protuberances (arrows) in the esophagus; B: Nodular protuberances (arrows) in the ileum; C: Nodular protuberances (arrows) in the colon.