D'Alitto, FeliciaFeliciaD'AlittoScherz, AminaAminaScherzMargini, CristinaCristinaMarginivon Tengg-Kobligk, HendrikHendrikvon Tengg-Kobligk0000-0003-3207-3223Montani, MatteoMatteoMontaniPabst, Thomas NiklausThomas NiklausPabstBerzigotti, AnnalisaAnnalisaBerzigotti0000-0003-4562-90162024-10-072024-10-072018-06-08https://boris-portal.unibe.ch/handle/20.500.12422/61225Portal hypertension (PH) is a common clinical syndrome leading to severe complications. In the western world, about 90% of cases of PH are due to liver cirrhosis, and thanks to the availability of ultrasound elastography methods, this diagnosis is usually confirmed at bedside. We report a case of a patient presenting with PH and ascites initially suspected of suffering from liver cirrhosis. The finding of large hepatomegaly and a massive increase in liver stiffness prompted us to perform a liver biopsy. This revealed no fibrosis, but diffuse primary amyloidosis (AL amyloidosis). We discuss the diagnostic and treatment of this case, with emphasis on non-invasive imaging methods available for diagnosis and follow up.enamyloidosis elastography hvpg liver biopsy liver cirrhosis multiple myeloma600 - Technology::610 - Medicine & health600 - Technologyarticle10.7892/boris.1220953010104710.7759/cureus.2768