How is AL amyloidosis diagnosed?

How is AL amyloidosis diagnosed?

Many tests can be performed to diagnosis amyloidosis. A biopsy (the removal of cells or tissue) of the affected organ(s) is the most useful test. A pathologist will examine the tissue under a microscope and perform special tests to identify the exact protein that is causing the amyloidosis.

Your doctor will talk to you about the biopsy/biopsies you need, which may include:

• Bone marrow biopsy: A small sample of bone marrow is removed from inside the bone. All patients with AL amyloidosis need a bone marrow biopsy.
• Kidney biopsy: An ultrasound is used to help guide a needle into the kidney. A few small pieces of tissue are removed.
• Heart biopsy: A small, thin, hollow tube (catheter) is guided to the heart through a vein in your neck. A few small pieces of the heart muscle are removed.
• Fat pad biopsy: A small piece of fat tissue is removed from your abdomen.

In addition to a biopsy, you may need other tests to find out how well your organs are working:

• Blood samples to check the kidneys, heart, liver and the amount of light chains in your blood.
• A 24-hour urine collection (done at home and returned to your doctor) to see if your kidneys are affected.
• Electrocardiogram (EKG) and echocardiogram (ultrasound of the heart).
• A cardiac MRI or a cardiac nuclear scan (technetium pyrophosphate scan) may be done to see if your heart is affected.