Localized interstitial pulmonary amyloid: a case report and review of the literature

BoydKing, Ayana; Sharma, Om P.; Stevenson, Kerry

doi:10.1097/mcp.0b013e32832d03d8

Cited by 16 publications

(8 citation statements)

References 9 publications

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“…As a rule, it is a manifestation of systemic amyloidosis, but unusual cases of diffuse alveolar-septal amyloidosis with no evidence of a systemic disease have been described [29,36,38]. It is usually associated with systemic AL amyloidosis, but cases of diffuse alveolar-septal amyloidosis that are caused by systemic AA, systemic ATTRwt and systemic hereditary ATTR amyloidosis have been reported [28,29,38].…”

Section: Diffuse Alveolar-septal Amyloidosismentioning

confidence: 99%

The lung in amyloidosis

et al. 2017

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Amyloidosis is a disorder caused by misfolding of autologous protein and its extracellular deposition as fibrils, resulting in vital organ dysfunction and eventually death. Pulmonary amyloidosis may be localised or part of systemic amyloidosis.Pulmonary interstitial amyloidosis is symptomatic only if the amyloid deposits severely affect gas exchange alveolar structure, thus resulting in serious respiratory impairment. Localised parenchymal involvement may be present as nodular amyloidosis or as amyloid deposits associated with localised lymphomas. Finally, tracheobronchial amyloidosis, which is usually not associated with evident clonal proliferation, may result in airway stenosis.Because the treatment options for amyloidosis are dependent on the fibril protein type, the workup of all new cases should include accurate determination of the amyloid protein. Most cases are asymptomatic and need only a careful follow-up. Diffuse alveolar-septal amyloidosis is treated according to the underlying systemic amyloidosis. Nodular pulmonary amyloidosis is usually localised, conservative excision is usually curative and the long-term prognosis is excellent. Tracheobronchial amyloidosis is usually treated with bronchoscopic interventions or external beam radiation therapy.

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Section: Diffuse Alveolar-septal Amyloidosismentioning

confidence: 99%

The lung in amyloidosis

et al. 2017

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“…[13] High resolution CT shows thickening of interlobular septum, network-like blurred shadows, or multiple subpleural nodules (2–4 mm in size). Lymph node amyloidosis is characterized by deposition of amyloid substances in lymph nodes in the mediastinum and pulmonary hilum.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of amyloidosis with isolated respiratory system involvement: A review of 13 cases

Chu¹,

Zhao²,

Zhang³

et al. 2012

Ann Thorac Med

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BACKGROUND:Isolated pulmonary amyloidosis is a very rare disease.METHODS:We retrospectively reviewed the records of patients with pathologically proven isolated pulmonary amyloidosis treated at our hospital from 1990 to 2011.RESULTS:There were 9 males and 4 females with a mean age of 54.7 years (range, 45–72 years) and the mean course of disease was 46.5 months (range, 5 months–15 years). The most common symptoms were cough (10/13), expectoration (8/13), hemoptysis (4/13), chest tightness (12/13), dyspnea (10/13), chest pain (3/13), fever (5/13), and body weight loss (2/13). Radiological findings included tracheal stenosis (2/13), bronchial stenosis with atelectasis (5/13), pulmonary nodules (3/13), lung consolidation (1/13), and lymph node enlargement with pleural effusion (2/13). Treatments included endotracheal stenting, endoscopic resection of tracheal and bronchial lesions, lung resection, and drug therapy with glucocorticoids, antineoplastic agents, or antibiotics. Four patients died of the disease within 1 year of diagnosis, 2 died of pneumonia at 3–4 years after original treatment, and the remaining patients are alive with follow-up ranging from 3 to 15 years.CONCLUSIONS:Isolated pulmonary amyloidosis is a rare disease with a relatively high mortality and its various manifestations make diagnosis challenging. Surgical resection of lesions and chemotherapy tend to be effective treatments.

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“…From images, it is very difficult to distinguish among primary lung tumors, lung metastases, other lung inflammatory pseudotumors, and lung/mediastinum nodular amyloidosis [5]. However, CT-guided percutaneous needle biopsy or endoscopic ultrasound biopsy has the greater value in the diagnosis of these diseases [6,7]. So far, the gold standard for the diagnosis of amyloidosis is the histological examination of biopsy tissues through Congo red (pink or rose red) and methyl violet (red or purple) staining, and polarized light microscopy showing the characteristic yellow-green two-color of double refraction bodies [8].…”

Section: Discussionmentioning

confidence: 99%

18F-FDG-PET-CT with Little Value in Different Diagnosis between Pulmonary Malignancy and Amyloidosis

Song¹

2014

J Hematol Thrombo Dis

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Pulmonary amyloidosis is rare and is often misdiagnosed due a lack of general awareness of the condition. The role of PET-CT in the differential diagnosis between pulmonary amyloidosis and lung malignant tumors is still unclear. Herein, we describe a 61-year-old Chinese woman who presented with a right lower lobe pulmonary nodule, and right hilar and mediastinal lymph nodes shadows. On PET-CT examination, the patient was found to have right lower lung malignant lesions with multiple right hilar and mediastinal lymph node metastases. She was diagnosed with nephrotic syndrome with a history of pathologic type of amyloidosis over the previous two months. After performing right thoracotomy, a histopathologic diagnosis of pulmonary amyloidosis was made. The patient has done well postoperatively, showing no local recurrence in the lung or deterioration of her condition in a 12-month follow-up period. The pathology of nephrotic syndrome in patients with amyloidosis led to the diagnosis of systemic amyloidosis being made in this patient. From this case, combined with the domestic and international literature, we conclude that PET-CT is of little value for the different diagnosis between pulmonary amyloidosis and lung malignant tumors.

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Localized interstitial pulmonary amyloid: a case report and review of the literature

Cited by 16 publications

References 9 publications

The lung in amyloidosis

The lung in amyloidosis

Clinical characteristics of amyloidosis with isolated respiratory system involvement: A review of 13 cases

18F-FDG-PET-CT with Little Value in Different Diagnosis between Pulmonary Malignancy and Amyloidosis

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