Obstructive jaundice caused by the deposition of amyloid-like substances in the extrahepatic and large intrahepatic bile ducts in a patient with multiple myeloma

Obstructive jaundice has rarely been reported in liver amyloidosis. We report here an autopsy of a 55‐year‐old woman with multiple myeloma and obstructive jaundice due to the deposition of amyloid‐like substances in the walls and lumina of the extrahepatic bile duct and intrahepatic large bile ducts, resulting in obstruction and narrowing of the bile ducts. The amyloid‐like deposits were negative with Congo red stain, and were negative immunohistochemically for IgG, IgA, IgM, kappa chain, beta‐2‐microglobulin, and amyloid A and P components. However, they were positive for lambda chain, and ultrastructurally composed of non‐branching filaments with a diameter of 7–10 nm. This is the first case of obstructive jaundice due to histologically confirmed amyloid‐like deposits in the biliary system.