“…A total of 95 articles published over a period of 63 years were included, representing a final sample of 196 patients with PA. Figure 1 shows the flow chart of the article selection process. [ 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 <...…”
Section: Resultsmentioning
confidence: 99%
“…Only nine cases[ 10 30 35 77 78 82 83 90 94 ] (4.6%) met the diagnostic criteria for primary amyloidosis (plasma cell proliferation, organ damage related to amyloidosis, positive Congo Red amyloid staining in some tissue, and evidence of amyloid light chain on electron microscopy). [ 10 ] Pleural biopsy was performed in 67 patient [(28 by closed pleural biopsy[ 18 30 33 34 38 39 41 42 45 47 49 55 60 61 88 ] and 30 by pleuroscopy (medical or surgical)[ 8 9 10 20 29 30 37 41 51 55 62 65 72 73 75 76 78 79 81 83 84 87 88 90 92 93 97 99 ], in 9 cases the type of biopsy was not detailed. [ 14 22 23 24 67 70 74 96 98 ]] Amyloid PE was confirmed in 56 patient [21 by closed pleural biopsy[ 18 30 33 34 42 45 47 49 60 61 ] and 29 by pleuroscopy;[ 8 …”
Section: Resultsmentioning
confidence: 99%
“…[ 10 ] Pleural biopsy was performed in 67 patient [(28 by closed pleural biopsy[ 18 30 33 34 38 39 41 42 45 47 49 55 60 61 88 ] and 30 by pleuroscopy (medical or surgical)[ 8 9 10 20 29 30 37 41 51 55 62 65 72 73 75 76 78 79 81 83 84 87 88 90 92 93 97 99 ], in 9 cases the type of biopsy was not detailed. [ 14 22 23 24 67 70 74 96 98 ]] Amyloid PE was confirmed in 56 patient [21 by closed pleural biopsy[ 18 30 33 34 42 45 47 49 60 61 ] and 29 by pleuroscopy;[ 8 9 10 20 29 30 37 41 51 55 62 65 72 73 75 76 ...…”
Section: Resultsmentioning
confidence: 99%
“…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%).…”
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.
“…A total of 95 articles published over a period of 63 years were included, representing a final sample of 196 patients with PA. Figure 1 shows the flow chart of the article selection process. [ 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 <...…”
Section: Resultsmentioning
confidence: 99%
“…Only nine cases[ 10 30 35 77 78 82 83 90 94 ] (4.6%) met the diagnostic criteria for primary amyloidosis (plasma cell proliferation, organ damage related to amyloidosis, positive Congo Red amyloid staining in some tissue, and evidence of amyloid light chain on electron microscopy). [ 10 ] Pleural biopsy was performed in 67 patient [(28 by closed pleural biopsy[ 18 30 33 34 38 39 41 42 45 47 49 55 60 61 88 ] and 30 by pleuroscopy (medical or surgical)[ 8 9 10 20 29 30 37 41 51 55 62 65 72 73 75 76 78 79 81 83 84 87 88 90 92 93 97 99 ], in 9 cases the type of biopsy was not detailed. [ 14 22 23 24 67 70 74 96 98 ]] Amyloid PE was confirmed in 56 patient [21 by closed pleural biopsy[ 18 30 33 34 42 45 47 49 60 61 ] and 29 by pleuroscopy;[ 8 …”
Section: Resultsmentioning
confidence: 99%
“…[ 10 ] Pleural biopsy was performed in 67 patient [(28 by closed pleural biopsy[ 18 30 33 34 38 39 41 42 45 47 49 55 60 61 88 ] and 30 by pleuroscopy (medical or surgical)[ 8 9 10 20 29 30 37 41 51 55 62 65 72 73 75 76 78 79 81 83 84 87 88 90 92 93 97 99 ], in 9 cases the type of biopsy was not detailed. [ 14 22 23 24 67 70 74 96 98 ]] Amyloid PE was confirmed in 56 patient [21 by closed pleural biopsy[ 18 30 33 34 42 45 47 49 60 61 ] and 29 by pleuroscopy;[ 8 9 10 20 29 30 37 41 51 55 62 65 72 73 75 76 ...…”
Section: Resultsmentioning
confidence: 99%
“…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%).…”
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.
Teaching Points• To recognise the various metabolic and storage lung diseases• To identify the characteristic imaging findings in various metabolic and storage lung diseases• To discuss the relevant differential diagnoses of each of these diseases
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
