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Mihalova TZ, Ivanova SS, Mekov EV, Yamakova YТ, Petkov RE. Ultrasound-controlled transthoracic true-cut needle biopsy in pulmonary nodular amyloidosis. Respirol Case Rep 2023; 11:e01142. [PMID: 37200954 PMCID: PMC10186149 DOI: 10.1002/rcr2.1142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/30/2023] [Indexed: 05/20/2023] Open
Abstract
The current case report presents a 59-year-old man with imaging studies of the thorax showing nodular lesions in the lungs bilaterally. Based on radiographic and CT images, preliminary diagnoses for possible granulomatosis (tuberculosis) or pulmonary metastatic dissemination of a neoplastic process were made. An ultrasound-controlled transthoracic true-cut needle biopsy of a subpleural lesion was performed. Special staining with Congo red and examination with a polarizing light microscope for detection of amyloid confirmed the diagnosis of 'pulmonary nodular amyloidosis' by visualizing green birefringence.
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Affiliation(s)
- Teodora Z. Mihalova
- Clinic for Treatment of Nonspecific Lung Diseases and TuberculosisUMHAT “St. Ivan Rilski”, Medical University—SofiaSofiaBulgaria
| | - Silviya S. Ivanova
- Department of PathomorphologyUMHAT "St. Ivan Rilski", Medical University—SofiaSofiaBulgaria
| | - Evgeni V. Mekov
- Department of Professional DiseasesUMHAT “St. Ivan Rilski”, Medical University—SofiaSofiaBulgaria
| | - Yordanka Т. Yamakova
- Department of Intensive Care, Clinic for CardiologyUMHAT “Alexandrovska”, Medical University—SofiaSofiaBulgaria
| | - Rosen E. Petkov
- Clinic for Treatment of Nonspecific Lung Diseases and TuberculosisUMHAT “St. Ivan Rilski”, Medical University—SofiaSofiaBulgaria
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Polo-Nieto JF, Quiroga-Dussan MDP, Castañeda-González JP, Fierro-Rodríguez DM, Durán-Acuña R, Carrillo-Bayona JA. Perilymphatic micronodular pattern as a manifestation of pulmonary amyloidosis on high-resolution computed tomography. Radiol Case Rep 2021; 16:850-854. [PMID: 33552338 PMCID: PMC7850939 DOI: 10.1016/j.radcr.2021.01.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/05/2021] [Accepted: 01/11/2021] [Indexed: 12/26/2022] Open
Abstract
The term amyloidosis describes a group of diseases caused by the fibrillar deposit of poorly folded proteins in tissues with a secondary alteration of their function. Diffuse parenchymal lung disease associated with amyloidosis is rare and is most often diagnosed in autopsy. A 45-year-old male patient presented an acute episode of cough with mucoid expectoration. He had also dyspnea, dry cough, chest pain, and constitutional symptoms of 6 months of evolution. Initially the case was treated as acute pneumonia. After taking radiological images of the thorax, a diagnostic suspicion of lymphangitic spread of neoplasia was assumed. Histopathological findings of an open pulmonary biopsy demonstrated interstitial thickening with perivascular eosinophilic invasion. Congo Red staining and immunohistochemistry studies were done and turned out to be positive for amyloid. The perilymphatic micronodular pattern as a radiological manifestation of parenchymal pulmonary amyloidosis has been very rarely described in the literature, therefore it must be considered as a differential diagnosis in patients with this pattern in CT scan and should be an incentive for its histopathological study once a neoplasm is ruled out.
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Affiliation(s)
- José Fernando Polo-Nieto
- Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
- Department of Pathology. Hospital de San José, Bogotá, Colombia
| | - Maria Del Pilar Quiroga-Dussan
- Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
- Department of Pathology. Hospital de San José, Bogotá, Colombia
| | - Juan Pablo Castañeda-González
- Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
- Department of Pathology. Hospital de San José, Bogotá, Colombia
| | - Diana Marcela Fierro-Rodríguez
- Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
- Department of Radiology. Hospital de San José, Bogotá, Colombia
| | - Ricardo Durán-Acuña
- Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
- Department of Pulmonology. Hospital de San José, Bogotá, Colombia
| | - Jorge Alberto Carrillo-Bayona
- Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
- Department of Radiology. Hospital de San José, Bogotá, Colombia
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Ohara S, Tomizawa K, Shimizu S, Suda K, Fujino T, Hamada A, Koga T, Nishino M, Kobayashi Y, Sato K, Chiba M, Shimoji M, Takemoto T, Soh J, Mitsudomi T. Primary pulmonary mucosa-associated lymphoid tissue lymphoma with amyloid light chain-type amyloidosis. Surg Case Rep 2019; 5:105. [PMID: 31243589 PMCID: PMC6595020 DOI: 10.1186/s40792-019-0663-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A total of 75% of patients with Sjögren's syndrome are complicated with pulmonary lesions, of which 12% are lymphoma and 6% are amyloid nodules; the coexistence of both is considered to be rare. CASE PRESENTATION A 67-year-old female with Sjögren's syndrome presented with multiple pulmonary nodules on chest computed tomography. Since a definitive diagnosis by transbronchial biopsy was not obtained, wedge resection of the nodules was performed. Pathologic diagnosis revealed eosinophilic deposition that stained positive with Congo red. In addition, lymphoepithelial lesions and lymphocytic infiltration were observed. Lymphocytes with monoclonal proliferation predominantly had κ chain. Based on these findings, the nodules were diagnosed as mucosa-associated lymphoid tissue (MALT) lymphoma with amyloid deposition. CONCLUSIONS The combination of these diseases is very rare, and this is the sixth resected case to the best of our knowledge.
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Affiliation(s)
- Shuta Ohara
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan.
| | - Kenji Tomizawa
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Shigeki Shimizu
- Department of Pathology, Faculty of Medicine, Kindai University, Ohno-Higashi, Osaka-Sayama, Japan
| | - Kenichi Suda
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Toshio Fujino
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Akira Hamada
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Takamasa Koga
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Masaya Nishino
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
| | | | - Katsuaki Sato
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Masato Chiba
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Masaki Shimoji
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Toshiki Takemoto
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Junichi Soh
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Tetsuya Mitsudomi
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
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Pulmonary amyloidosis with calcified nodules and masses - a six-year computed tomography follow-up: a case report. CASES JOURNAL 2009; 2:6540. [PMID: 19918529 PMCID: PMC2769299 DOI: 10.4076/1757-1626-2-6540] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Accepted: 07/22/2009] [Indexed: 11/16/2022]
Abstract
Introduction Pulmonary amyloidosis is an uncommon disease, characterized by extracellular deposition of fibrillary protein in the lungs. It appears in three forms: tracheobronchial, nodular pulmonary, and alveolar septal. There are few reports of long-term observation of primary pulmonary amyloidosis. Case presentation We present the case of a 47-year-old man who presented with fever, dyspnea, cough and hemoptysis. Chest radiograph and computed tomography revealed multiple pulmonary nodules and masses. The patient underwent open lung biopsy, which diagnosed pulmonary amyloidosis. Conclusion Pulmonary nodular amyloidosis should be considered in the differential diagnosis of pulmonary nodules or masses.
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