Multiple amyloidomas in an HIV patient presented as inguinal and mediastinal masses: a case report diagnosed by fine-needle aspiration

Systemic amyloidosis can occur rarely as multiple masses with replacement of lymph nodes, causing lymphadenopathy and potentially mimicking neoplasms. We report a case of multiple amyloidomas in the inguinal lymph nodes and mediastinum in a 30-yr-old HIV positive woman with remote history of high grade dysplasia. Abundant amorphous material was obtained on fine-needle aspiration, making metastatic squamous cell carcinoma with abundant keratin a potential differential diagnosis. The prudent use of special stains such as Congo red, crystal violet, and immunohistochemical stains for keratin and kappa and beta light chains can be invaluable in helping to clarify the diagnosis. In patients with chronic inflammation, amyloidomas must be considered in the differential diagnosis of mass lesions so the appropriate work-up can be undertaken to minimize this potential pitfall.