Diffuse alveolarseptale Lungenamyloidose

Diffuse alveolar septal amyloidosis in generalised amyloidosis

A case of generalized amyloidosis is reported which diffusely involved the alveolar septa. A 67-year-old Japanese housewife showed no clinical evidence of systemic disease. She had complained of anorexia and diarrhea for a year and finally died of pneumonia-like symptom. Autopsy revealed a generalized amyloidosis, in which amyloid materials deposited beneath the basement membrane prominently in alveolar septa, and slightly in glands of alimental tract, thyroid and kidneys, perireticularly in the myocardium and adipose tissues, focally in the interstitial spaces of urogenital tract, thyroid, eosphagus and pancreas, and within the walls of small blood vessels in many organs No amyloid tumor was detected in the respiratory system. Severe alveolar septal amyloidosis occurred diffusely in both lungs in this case. The arrangement of amyloid deposition in the lungs was discussed in relation to gas diffusion in the alveolar walls.

Senile pulmonary amyloidosis

Lung tissue obtained from 340 necropsies of persons aged 80 years and over was investigated for the occurrence of pulmonary amyloid deposits by means of a sensitive fluorescence technique. The incidence of pulmonary amyloidosis was about 2% below the age of 80, nearly 10% in individuals between 80 and 84 years, and more than 20% at and beyond 85 years. Vascular and concomitant alveolar-septal amyloidosis was seen slightly more often than the pure septal form of senile amyloidoisis. The two modes of deposition correspond to two different forms of cardiac amyloidosis, vascular and nodular. On the other hand, the two different modes of pulmonary amyloidosis affect different age groups. It is postulated that the disorder is related to age-linked immunological disturbances and to genetically determined factors.

Pulmonary alveolar septal amyloidosis. A scanning- and transmission electron microscopy study

A case of primary amyloidosis is presented with diffusely involved the alveolar septa. The lung was studied by light microscopy and by transmission and scanning electron microscopy. The fine structure of the amyloid material showed it to be porous, homogeneous, and an acellular substance consisting of interwoven bundles of amyloid fibrils. The fine structure of the amyloid material was considered to explain the normal gas diffusion across the alveolar respiratory membrane. The diagnosis of amyloidosis was first made from a uterine cervical biopsy specimen.

Primary diffuse tracheobronchial amyloidosis

The case is reported of a woman who died at the age of 36 years from obstructive respiratory failure due to diffuse tracheobronchial amyloidosis which had caused symptoms for six years. When first seen her symptoms of wheezing cough and mucopurulent sputum sometimes streaked with blood were of recent onset, but on bronchogram and bronchoscopy her disease was already widespread. Appearances at bronchography were interpreted as malformation and at bronchoscopy as tracheobronchitis, possibly tuberculous. Bronchoscopic biopsy was necessary to make the diagnosis of amyloidosis. The amyloid gave the usual staining reactions with an apple-green birefringence in polarized light following staining with Congo red. At necropsy an extensive histological survey proved that the amyloid was confined to the trachea and main stem bronchi. There was no associated disease, no family history, and no upset in plasma proteins.