Journal Information
Vol. 57. Issue 3.
Pages 227 (March 2021)
Clinical Image
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Pulmonary nodular amyloidosis. A rare cause of multiple pulmonary nodules
Amiloidosis nodular pulmonar, una causa infrecuente de nódulos pulmonares múltiples
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Inés Ruiz-Álvareza,
Corresponding author
inesrual@gmail.com

Corresponding author.
, Ana M. Gutiérrez Palaciosb, Beatriz Rodríguez Díazc
a Servicio de Neumología, Hospital Vital Alvarez-Buylla, Mieres, Asturias, Spain
b Servicio de Anatomía Patológica, Hospital Vital Alvarez-Buylla, Mieres, Asturias, Spain
c Servicio de Medicina Interna, Hospital Vital Alvarez-Buylla, Mieres, Asturias, Spain
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A 45-year-old woman with a history of mucosa-associated lymphoid tissue non-Hodgkin lymphoma, with complete response after treatment. A follow-up computed tomography (CT) scan showed multiple nodular lesions in a subpleural location and pulmonary cysts (Fig. 1A) with low uptake on positron emission tomography-computed tomography (PET-CT) (SUVmax. 1.3). Incidental findings on mammography included a breast node and a skin lesion in the lower limb that was biopsied, giving a diagnosis of AL amyloidosis (kappa-light chain). In view of suspected pulmonary nodular amyloidosis (PNA), a CT-guided core needle biopsy was performed that showed Congo red-positive material (Fig. 1B) and intensely positive kappa light chains in the immunohistochemical study, giving a diagnosis of systemic amyloidosis (AL) kappa-light chain.

Figure 1.

Amyloidosis.

(0.18MB).

PNA is an uncommon disease characterized by the presence of one or more amyloid tissue deposits in the lung. Primary amyloidosis is the most common, while systemic amyloidosis is rare. Patients are usually asymptomatic, and the disease is detected by an incidental finding in imaging studies showing well-defined nodules of subpleural distribution measuring 0.4−5 cm. Histological analysis revealing eosinophilic material stained with Congo red with apple green birefringence is necessary for diagnosis.1,2

References
[1]
A. Khoor, T.V. Colby.
Amyloidosis of the lung.
Arch Pathol Lab Med, 141 (2017), pp. 247-254
[2]
A.C. Aylwin, P. Gishen, S. Copley.
Imaging appearance of thoracic amyloidosis.
J Thorac Imaging, 20 (2005), pp. 41-46

Please cite this article as: Ruiz-Álvarez I, Gutiérrez Palacios AM, Rodríguez Díaz B. Amiloidosis nodular pulmonar, una causa infrecuente de nódulos pulmonares múltiples. Arch Bronconeumol. 2021;57:227.

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Archivos de Bronconeumología

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