Abstract
Light chain (AL) amyloidosis presenting predominantly with hepatomegaly is a rare and frequently misdiagnosed condition. While clinical features are non-specific, elevated ALP/GGT should raise suspicion. A liver biopsy remains the gold standard for diagnosis. Although there is no disease-specific therapy for hepatic amyloidosis, timely chemotherapy initiation-particularly monoclonal antibody-based regimens-can significantly improve prognosis and lead to symptom resolution.