Spontaneous Resolution of a Pulmonary Cystic Amyloidosis Mass

Abstract

Introduction: Amyloidosis is a rare illness characterized by the deposition in organs of amyloid, which can be detected by histological staining. Amyloidosis restricted to the lower respiratory tract is unusual. Results: We reported the case of a 68-year-old woman with no history of chronic disease who presented with dyspnoea on exertion, cough and fatigue. The physical examination was unremarkable. A CT scan showed a cystic mass with a thickened wall in the apical segment of the left lower lobe. A biopsy of the mass was performed, and histological and immunohistochemical study confirmed the diagnosis of AL amyloidosis. The patient’s clinical and radiological symptoms spontaneously improved without treatment after 3 years. Conclusion: Amyloid-related cystic lung disease is a rare presentation of amyloidosis in the thorax. More case reports are required to determine if such masses can resolve without treatment and whether amyloid-associated cystic lung disease actually exists.

Pulmonary Amyloidoma: A Case Report and Brief Review of the Literature

“…The scientific literature indicates that amyloidosis can manifest as a diffuse process with systemic involvement or be localized to a particular organ. The primary organs involved are the kidneys, heart, digestive tract, liver, and skin [5,6]. Respiratory involvement occurs in 50% of the patients with amyloidosis [7] in different clinical and radiological patterns [6].…”

“…The primary organs involved are the kidneys, heart, digestive tract, liver, and skin [5,6]. Respiratory involvement occurs in 50% of the patients with amyloidosis [7] in different clinical and radiological patterns [6]. Depending on the anatomic site of involvement [8], three histopathological patterns are recognized: diffuse alveolar-septal, nodular, and tracheobronchial [4,6,7].…”

“…Respiratory involvement occurs in 50% of the patients with amyloidosis [7] in different clinical and radiological patterns [6]. Depending on the anatomic site of involvement [8], three histopathological patterns are recognized: diffuse alveolar-septal, nodular, and tracheobronchial [4,6,7]. Other classifications have been proposed based on radiographic or bronchoscopic findings [2].…”

“…The most common pattern is AL light chain (AL) amyloidosis, with an occurrence consecutive to the deposition of excess immunoglobulin light chain fragments, subsidiarily with a substrate of plasma cell dyscrasia [9,10]. AL amyloidosis accounts for approximately 70% of all systemic amyloidosis cases [9], or 63-80% in other sources [6]. The second type of amyloid is reactive systemic AA amyloidosis, caused by the accumulation of the acute-phase reactant serum amyloid A, which occurs secondary to various chronic inflammatory conditions [11].…”