Cardiac magnetic resonance image of the study patient at the time of diagnosis. The delayed enhancement image displays subendocardial enhancement at both the left and right ventricle walls (A). Pathology of the initial endomyocardial biopsy (B, C). Congored stain showing positivity for amyloid deposits. Under polarized light, amorphous materials showing an apple-green birefringence were evident (B). Immunohistochemical staining results: prealbumin (+); kappa chain (++); lambda chain (-); amyloid A (-) (C).