Bilateral local primary parotid gland amyloidosis, a case report and literature review

Abstract Amyloidosis of the salivary glands is a rare occurrence. It is an extremely uncommon manifestation of systemic amyloidosis and an even less common manifestation of primary amyloidosis. Here, we present a case of an 80-year-old female with a history of rheumatoid arthritis who presented with bilateral parotid masses and ear pain radiating to the shoulders. Fine needle aspiration revealed a cellular specimen with no atypical features, with abundant amorphous material. On Diff-Quick preparation the amorphous material showed a deep blue, while on Pap stain it was brightly eosinophilic. A cell block was prepared and demonstrated characteristic staining with Congo red. The material displayed the typical birefringence under polarized light microscopy. This case is an example of a rare presentation of amyloidosis and demonstrates the utility of fine needle aspiration (FNA) for the diagnosis of amyloidosis.