Introduction
Nodular pulmonary amyloidosis (NPA) is a localized form of AL amyloidosis often found incidentally and typically has an indolent and benign disease course treated with resection or local excision. We present a patient with recurrent localized AL amyloidosis who required further treatment.
Case Description
A 63-year-old female with MGUS was found to have pulmonary AL amyloid on wedge resection and later had recurrence. The patient did not have signs of a clonal plasma cell proliferation or systemic AL amyloid. She was treated with Daratumumab, Cyclophosphamide, Bortezomib, and Dexamethasone. After initiation of treatment the patient has had significant hematologic and radiographic response.
Conclusion
The patient had nodular pulmonary amyloidosis recurrence with organ dysfunction without systemic disease. Because the presentation of recurrent pulmonary AL amyloidosis is rare there is no published evidence on treatment. However, the patient has had hematologic and radiographic improvement after initiating treatment with a systemic protocol.