What is the role of biopsy in the workup of nodular localized cutaneous amyloidosis (NLCA)?

Updated: Nov 15, 2016
  • Author: Nicholas V Nguyen, MD; Chief Editor: Dirk M Elston, MD  more...
  • Print

Skin biopsy provides the definitive diagnosis. No special tissue preparation or handling is required before delivering the specimen to the laboratory. Special stains and immunohistochemistry are helpful.

An optimal biopsy specimen includes the epidermis, papillary dermis, and reticular dermis. The amyloid in nodular localized cutaneous amyloidosis is located in the reticular dermis and subcutaneous fat, and clearly differentiates nodular localized cutaneous amyloidosis from other forms of amyloidosis. A shave biopsy or other superficial sample may not include enough reticular dermis to complete the diagnosis.

Consider bone marrow biopsy with gene rearrangement studies (if available) to exclude multiple myeloma.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!