Aspiration cytology performed on the lower abdominal fat pad is a relatively safe, easy and inexpensive method to diagnose systemic amyloidosis.
Site selection: lower quadrant, below the umbilicus and lateral to the midline
The skin is carefully cleaned then anesthesized with 1% lidocaine.
The aspirated material can be:
(1) stained by Congo red stain or it can be
(2) sent for amyloid protein analysis (not available in many hospitals)
(3) sent for electron microscopy
The phenol Congo red stain is more sensitive than the standard alkaline stain for detecting amyloid in fat.
The performance depends on the amount of amyloid deposited. The sensitivity has been reported as about 80%. It is affected by the severity of the amyloidosis and experience of the operator.
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