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. 2022 Dec 5;9:1081098. doi: 10.3389/fcvm.2022.1081098

FIGURE 6.

FIGURE 6

Male of 81 years affected by kappa light chain low grade multiple myeloma, with score 2 cardiac uptake on scintigraphy with bone tracers. Endomyocardial biopsy was performed for suspected cardiac amyloidosis and showed slight to moderate myocardial interstitial and subendocardial amyloid deposits. Proteomic analysis with mass spectrometry in tandem mode was positive for TTR proteotypic peptides. IHC failed to type amyloid with both commercial and specific antibodies. Immunolabeling was strong and diffuse with all antibodies with no significant differences in intensity and distribution. (A–C) Histology of a biopsy fragment showing subendocardial and myocardial eosinophilic amorphous deposits with Hematoxylin-Eosin (A: 50×), bluish-gray deposits with Azan Mallory trichrome (B: 50×) and green birefringent deposits with Congo red under polarized light (C: 50×). Specific antibodies (amY-kit reduced PeloBiotech). (D) Anti-ATTR-TIE (50×). (E) Anti-kappa-KRA/KUN (50×). (F) Anti-lambda-UTI/LAT (50×). Commercial antibodies against native proteins. (G) Anti-ATTR AbCam, clone EP2929Y (50×). (H) Anti-kappa Roche-Ventana (50×). (I) Anti-lambda Roche-Ventana (50×).