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Localized Amyloid Deposition at the Ampulla of Vater.

A 77-year-old man presented at our hospital with general fatigue. He underwent an endoscopic examination to check for any malignancies. Esophagogastroduodenoscopy revealed a submucosal tumor-like elevated lesion at the ampulla of Vater. The surface of the lesion was whitish and smooth without any depressions (Picture 1A, arrows). A magnifying endoscopic examination with narrow-band imaging revealed a nonstructural surface pattern with telangiectasia (Picture 1B). An endoscopic biopsy revealed the deposition of an eosinophilic nonstructural substance in the mucosa (Picture 2A, oval), with a reddish-brown appearance on direct fast scarlet (DFS) staining and an apple-green appearance