Abstract: Objective To explore the clinical manifestation，diagnosis，differential diagnosis，treatment，and prognosis of light chain systemic amyloidosis，and to improve the clinical understanding of systemic amyloidosis. Methods A case of systemic amyloidosis involving multiple organs with tongue damage as the first manifestation in the Department of Oncology of the Fourth Hospital of Wuhan in 2022 was reported，and the related clinical contents of the disease were analyzed. Results A 64-year-old male patient presented with stiff cheeks and tongue. Tongue amyloidosis was diagnosed by a series of related examinations and then treated with thalidomide and prednisone. Conclusion Amyloidosis has a variety of clinical manifestations and can involve multiple organs. The prognosis is poor. Most clinical manifestations are not specific，but tongue hypertrophy and periorbital purpura are more specific clinical manifestations of light chain amyloidosis. Clinically，it is often differentiated from M-proteinemia，such as multiple myeloma. The diagnosis mainly depends on the pathological examination of biopsy tissue. Chemotherapy is the main treatment.

Key words: tongue damage, systemic amyloidosis, diagnosis, treatment