A 173-year-old man with IgGλ multiple myeloma developed macroglossia due to amyloidosis of the tongue. The edge of the tongue shows dental indentations and there are multiple nodular lesions in the lips. The serum IgG was 5980 mg/dL with Bence Jones proteinuria, and a bone marrow aspirate contained 69% myeloma cells. The disease was refractory to chemotherapy and the patient died of congestive heart failure. Post-mortem examination revealed amyloid infiltration in various organs, including the heart, lungs, liver, spleen, kidneys, stomach and skin, as well as tongue and lips.

Figure 1.