Two cases of monoclonal nodular pulmonary amyloidosis and review of the literature

Abstract

Nodular pulmonary amyloidosis (NPA) is an uncommon pathology of insoluble protein depositing in pulmonary parenchyma. This localized pulmonary form of amyloidosis is most often found to contain combinations of kappa and lambda immunoglobulin light chain and immunoglobulin heavy chain proteins with a polyclonal lymphoplasmacystic infiltrate. Herein we present two cases of NPA of the rarely reported monoclonal (light-chain restricted) form with review of the literature and discussion of the clinical, radiographic, and histologic features of NPA.

Bilateral pulmonary nodular amyloidosis with positive fdg uptake

“…In amyloidosis fine needle aspiration biopsy has low field in diagnosis. Although CT-guided biopsies are reported to have a better chance of providing diagnostic material, most cases of pulmonary amyloidosis have been diagnosed only following surgical resection or at autopsy [1,2,4,7,8]. Similarly, in our case the final diagnosis was achieved following surgical resection.…”

“…Amyloidosis is a disease characterized by extracellular deposition of amyloid protein in tissue and organs such as kidney, liver, spleen, lung, gastrointestinal tract, endocrine organs, skin, heart or the autonomous nervous system [1,2]. Many types of amyloid have been described and all share the characteristics of fibrillary B-pleated sheet configuration.…”

“…Peripheral or subpleural involvement is more frequent in lower lobes, which grow slowly. However, systemic type shows a diffuse alveolar septal involvement and radiologic changes may be absent [1][2][3][4].…”