Diagnosis: Nodular Amyloidosis

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These deposits have the characteristic
waxy appearance of amyloid.

Additional studies would include 
thioflavin T stain (fluorochrome dye)
for confirmation of amyloid.  
Congo red could also be done. 

Nodular amyloidosis implies a localized, 
tumor-like deposit not associated with 
systemic disease but it may be necessary 
to first do a clinical workup for systemic 
amyloidosis and also do immunophenotyping 
of the deposit using antibodies to kappa, lambda,
Anti-AA, and Anti-prealbumin before reaching 
that conclusion.

Anti-amyloid substance P could also
be done.

In my experience, this is quite rare.
I can only recall seeing
two previous patients with nodular 
amyloidosis.  

There is one patient in the clinic 
that is currently being followed by 
hematology and dermatology over 
the last 3-4 years,who seems to have 
localized nodular amyloidosis.