Pathology · single question

Which oral finding in this patient is MOST likely due to amyloidosis associated with multiple myeloma?

  1. Palatal pigmentation
  2. Macroglossia with tongue scalloping
  3. Strawberry gingivitis
  4. White hairy leukoplakia
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Correct answer: B. Macroglossia with tongue scalloping

AL amyloidosis (immunoglobulin light chain) is the most common amyloid type in multiple myeloma. Deposition in the tongue produces macroglossia with lateral scalloping from pressure against the teeth. Other oral findings include waxy papules, submucosal hemorrhage, and xerostomia. Biopsy stained with Congo red shows apple-green birefringence under polarized light.

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