How common is it to have a negative flow cytometry result alongside a positive Congo red stain on a bone marrow biopsy for amyloidosis?
This is a really important and nuanced question. Unfortunately, the exact frequency of this specific combination isn't well-documented in available resources, and it's a topic best Show Full Answer
How common is it to have a negative flow cytometry result alongside a positive Congo red stain on a bone marrow biopsy for amyloidosis?
This is a really important and nuanced question. Unfortunately, the exact frequency of this specific combination isn't well-documented in available resources, and it's a topic best explored with a hematologist who specializes in amyloidosis.
Here's what is known about these two tests in the context of amyloidosis:
- Congo red stain is the gold standard for confirming amyloid deposits in a biopsy — a green appearance under a special microscope confirms amyloid proteins are present
- Flow cytometry looks at abnormal plasma cells in the bone marrow, which is more relevant for identifying AL amyloidosis specifically
- It is possible to have confirmed amyloid deposits (positive Congo red) without a detectable abnormal plasma cell population on flow cytometry
- This can happen in ATTR amyloidosis (both hereditary and wild-type), where plasma cells are not the source of the problem
This kind of result can make pinpointing the *type* of amyloidosis more challenging, which is why additional testing — like a serum free light-chain assay or genetic testing — is often needed. Bringing these specific results to a specialist in amyloidosis is strongly recommended, as interpreting this combination requires expert clinical judgment and likely further testing to determine the underlying type and best treatment path.
July 24
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