Systemic amyloidosis and malignant disease

Among 8,758 necropsies there are 93 cases of systemic amyloidosis. Of these, 14 are associated with malignancy: seven with myelomatosis or malignant lymphoma, and seven with carcinoma. The incidence of amyloidosis in myelomatosis is at least 10%. Attention is drawn to the presence of amyloid in the tubular casts of `myeloma kidney'. In Hodgkin's disease the incidence is about 4% but it may be higher in patients receiving chemotherapy. In lymphosarcoma it is of the order of a fraction of 1% but in macroglobulinaemia, essential or associated with malignant lymphoma, the incidence is considerably higher. Systemic amyloid is found in one in 375 of patients with carcinoma and in only a single patient among 1,500 `control cases'. Renal carcinoma accounts for one-quarter of all carcinomas associated with systemic amyloid. The other carcinomas originate in a variety of organs. In myelomatosis, amyloid may be found in the tumour deposits. In Hodgkin's disease and in lymphosarcoma there appears to be greater amyloid deposition in neoplastic tissue than hitherto realized. The carcinomas provide a striking example of topographical association of amyloid and tumour, the two being closely related in six of seven cases.