Amyloid in endobronchial ultrasound‐guided transbronchial needle aspiration cytology

Chen, Hannah H.; Kılıç, Ayşe; Picken, Maria M.; Pambuccian, Stefan E.; Wojcik, Eva M.

doi:10.1002/dc.23690

Cited by 4 publications

(6 citation statements)

References 15 publications

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“…PE was bilateral in 59/107 patients (55%), right sided in 36 (34%)[ 8 9 11 14 17 20 22 27 29 32 33 34 37 41 42 43 45 48 51 55 56 65 67 76 79 83 86 88 91 94 99 101 ] and left sided in 12 (11%). [ 13 23 24 30 35 38 46 60 69 81 97 ] PE was not identified as unilateral or bilateral in 89 cases (45%).…”

Section: Resultsmentioning

confidence: 99%

“…PE appearance was described in 44 cases (22%): PF was serous in 28 (63%), milky in 6 (14%),[ 10 21 48 54 61 91 ] hematic in 6 (14%)[ 27 30 31 55 81 ] and serohematic in four patients (9%). [ 44 76 77 86 ] The smell of PE was not described in any fluid. The biochemical characteristics and nucleated cell count in PF were available for 95 cases (48.5%) [ Table 3 ].…”

Section: Resultsmentioning

confidence: 99%

“…Response to treatment was defined as the total or partial control of PE or its symptoms. Only 31 (12.4%) patients showed good response to treatment (6 with the first treatment administered,[ 15 20 32 44 54 83 ] 14 with the second,[ 8 11 38 43 46 58 59 60 77 79 80 84 86 96 ] 6 with the third[ 10 47 51 63 78 ] and 5 with the fourth treatment administered[ 28 40 48 66 67 ]). Table 4 details the most frequent treatments or procedures (used in at least five cases).…”

Section: Resultsmentioning

confidence: 99%

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Characteristics of pleural effusion due to amyloidosis

Ferreiro¹,

Pou²,

Suárez-Antelo³

et al. 2023

Annals of Thoracic Medicine

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The characteristics of patients with pleural amyloidosis (PA) are poorly known. A systematic review was performed of studies reporting clinical findings, pleural fluid (PF) characteristics, and the most effective treatment of PA. Case descriptions and retrospective studies were included. The review included 95 studies with a total sample of 196 patients. The mean age was 63 years, male/female ratio was 1.6:1, and 91.9% of patients were >50 years. The most common symptom was dyspnea (88 patients). PF was generally serious (63%), predominantly lymphocytic, and with the biochemical characteristics of transudates (43.4%) or exudates (42.6%). Pleural effusion was generally bilateral (55%) and <1/3 of the hemithorax (50%), although in 21% pleural effusion (PE) exceeded 2/3. Pleural biopsy was performed in 67 patients (yield: 83.6%; 56/67) and was positive in 54% of exudates and 62.5% of unilateral effusions. Of the 251 treatments prescribed, only 31 were effective (12.4%). The combination of chemotherapy and corticosteroids was effective in 29.6% of cases, whereas talc pleurodesis was effective in 21.4% and indwelling pleural catheter in 75% of patients (only four patients). PA is more frequent in adults from 50 years of age. PF is usually bilateral, serous, and indistinctly a transudate or exudate. A pleural biopsy can aid in diagnosis if effusion is unilateral or an exudate. Treatments are rarely effective and there may be definitive therapeutic options for PE in these patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Characteristics of pleural effusion due to amyloidosis

Ferreiro¹,

Pou²,

Suárez-Antelo³

et al. 2023

Annals of Thoracic Medicine

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“…EBUS‐TBNA/EUS‐FNA for the diagnosis of nodal amyloidosis has been previously reported, but mostly as single case reports (EBUS, 30–35 or EUS 36,37 ) variably typed with IHC, and none using MS‐based analysis. To our knowledge, our study is the largest series of EBUS‐TBNA/EUS‐FNA–detected amyloid deposits in LNs and with amyloid subtyping by MS possible in all cases.…”

Section: Discussionmentioning

confidence: 99%

Role of EBUS‐TBNA/EUS‐FNA and mass spectrometry for diagnosis and typing of lymph node amyloidosis: 10‐year experience in two tertiary care academic centers

Naqvi,

Bonert,

Finley

et al. 2023

Cancer Cytopathology

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BackgroundThe objectives of this study were to investigate the utility of endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA)/endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) for the diagnosis of amyloidosis coupled with the feasibility of mass spectrometry (MS) for amyloid subtyping.MethodsAll patients who had amyloid diagnosed by EBUS‐TBNA/EUS‐FNA at two tertiary care centers from 2011 to 2020 were retrieved along with the MS subtype, clinical findings, and outcomes.ResultsEight patients were included: seven underwent EBUS‐TBNA of mediastinal lymph nodes, and one underwent EUS‐FNA of a periportal lymph node. Ages ranged from 37 to 79 years (median, 69 years), with equal numbers of men and women. Presenting clinical history included one case each of follicular lymphoma, lymphoplasmacytic lymphoma, rheumatoid arthritis, possible sarcoid, cirrhosis, and chronic renal insufficiency, and one case each of suspected pulmonary and cardiac amyloidosis. All cases showed waxy, amorphous material on direct smears (n = 5) or ThinPrep slides (n = 3), which were confirmed as amyloid on Congo Red staining. Immunohistochemistry showed dominant lambda staining in two of three cases. MS was performed in all cases and identified five of the light‐chain (AL) type, one of the heavy‐chain/AL type, and two suggestive of AL amyloidosis. Bone marrow biopsy performed in seven patients demonstrated that three had monoclonal plasma cells and one had lymphoplasmacytic lymphoma. Two of four patients with systemic amyloidosis received chemotherapy and remained alive, whereas three with localized disease remained stable under observation.ConclusionsEBUS‐TBNA/EUS‐FNA is effective for amyloidosis diagnosis and provides adequate material for ancillary tests, including MS, which can identify the precursor amyloidogenic protein, leading to appropriate patient management.

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“…Amyloidosis can present as a systemic disease, or, as a focal, localized mass (amyloidoma) . Amyloidoma, though unusual, has been described in the respiratory tract, urinary system, gastrointestinal tract, and rarely in the soft tissues . Although features of amyloid have been well described in surgical specimens, it has been seldom described in cytology, where it can be easily mistaken for other entities.…”

Section: Introductionmentioning

confidence: 99%

Cytological diagnosis of amyloidosis presenting as a supraclavicular swelling

Rakheja

Handa

Tahlan

et al. 2019

Diagnostic Cytopathology

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Amyloidosis is a well-recognized entity, that can present as a systemic disease, or, uncommonly, as a localized mass. We report here, a rare presentation of amyloidosis presenting as a supraclavicular swelling, diagnosed on fine-needle aspiration cytology. Subsequent bone marrow examination led to the diagnosis of multiple myeloma.This case highlights the need to be aware of cytological characteristics of amyloidosis, which can have unusual presentation posing a diagnostic dilemma.

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Amyloid in endobronchial ultrasound‐guided transbronchial needle aspiration cytology

Cited by 4 publications

References 15 publications

Characteristics of pleural effusion due to amyloidosis

Characteristics of pleural effusion due to amyloidosis

Role of EBUS‐TBNA/EUS‐FNA and mass spectrometry for diagnosis and typing of lymph node amyloidosis: 10‐year experience in two tertiary care academic centers

Cytological diagnosis of amyloidosis presenting as a supraclavicular swelling

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