Light chain amyloidosis case. A 76 year old with cardiac involvement who had electromechanical dissociation and heart failure and expired despite melphalan chemotherapy. A. Cardiac MRI following gadolinium injection demonstrates subendocardial delayed enhancement in the left ventricle and transmural delayed enhancement in the right ventricle. B. Gross specimen showing thick left and right ventricles. C and D. Congo red stain without (C) and with polarized light (D) demonstrates diffuse interstitial infiltration (arrowhead) and perivascular infiltration (arrow) of amyloid substance.
Migrino et al. BMC Medical Physics 2009 9:5 doi:10.1186/1756-6649-9-5