Why the study?
The clinicopathological features of prostatic transthyretin-derived amyloid (ATTR) deposition in sporadic cardiac ATTR amyloidosis (sATTR-CA), how prostatic deposition severity correlates with cardiac involvement, and which prostatic deposition patterns predict severe cardiac involvement required evaluation.
Does the severity of prostatic transthyretin-derived amyloid deposition correlate with the severity of cardiac amyloid deposition in male autopsy cases with sporadic cardiac ATTR amyloidosis?
Observational (n=35)
Does the severity of prostatic transthyretin-derived amyloid deposition correlate with the severity of cardiac amyloid deposition in male autopsy cases with sporadic cardiac ATTR amyloidosis?
Prostatic ATTR deposition is prevalent in patients with sporadic cardiac ATTR amyloidosis and correlates with the severity of cardiac amyloid involvement, suggesting prostate tissue may be useful for diagnosing and assessing the severity of sATTR-CA.
Prostatic ATTR deposition was associated with cardiac severity in autopsies; leaves open whether prostate sampling aids sATTR-CA diagnosis or assessment.
This study aimed to evaluate the clinicopathological features of prostatic transthyretin-derived amyloid (ATTR) deposition in patients with sporadic cardiac ATTR amyloidosis (sATTR-CA), investigate the correlation between the severity of amyloid deposition in the prostate and heart, and identify prostatic deposition patterns that could predict severe cardiac involvement. We evaluated 35 male autopsy cases with sATTR-CA. The severity of prostatic and cardiac ATTR deposition was assessed semiquantitatively. Using digital pathology, we quantitatively evaluated the immunohistochemical deposition burden of ATTR in the prostatic interstitium and myocardium. Amyloid deposition was detected in 18 cases (51%) in haematoxylin and eosin (H&E)-stained specimens, and ATTR deposition was confirmed in 29 cases (83%) using Congo red staining and immunohistochemistry for transthyretin. The group with identifiable amyloid deposition in the prostate on H&E staining had significantly more severe ATTR deposition in the heart than the group without prostatic deposition. The severity of deposition at all prostatic sites correlated positively with semiquantitative and quantitative deposition severity scores in the heart. Notably, the severity of deposition in the prostatic intraglandular interstitium and extraglandular vessels showed a strong positive correlation with the severity of sATTR-CA. Prostatic ATTR deposition was prevalent and may be a useful organ for diagnosing ATTR deposition. Additionally, the severity of prostatic deposition correlated with the severity of cardiac deposition. As biopsy materials often lack extraglandular tissue, it is crucial not to overlook intraglandular interstitium deposits on H&E staining.
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Ichimata et al. (2025) conducted an observational in Sporadic cardiac transthyretin-derived (ATTR) amyloidosis (sATTR-CA) (n=35). Prostatic transthyretin-derived amyloid (ATTR) deposition vs. Cases without identifiable prostatic amyloid deposition on H&E staining was evaluated on Prevalence of prostatic ATTR deposition and correlation with severity of cardiac ATTR deposition.
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