Imaging features of pulmonary involvement in a case of systemic amyloidosis: A classic case

Pattharapong Saneha, Thanarak Tongsuk, Laksika Bhuthathorn
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Abstract

Amyloidosis is a disease caused by pathologic extracellular deposition of abnormal insoluble proteins throughout the body [1]. Pulmonary amyloidosis is a form of amyloid deposition confined in the lung parenchyma and may cause airway obstruction, dysphagia, and chronic pleural effusions, often with nonspecific chest imaging findings [1,2]. A 56-year-old male with underlying light chain multiple myeloma and systemic amyloidosis presented with fever for 2 days without dyspnea or cough.  Further chest imaging revealed nonspecific findings including consolidations, ground-glass opacities, interlobular septal thickening in both upper lobes, and bilateral pleural effusions; a diagnosis of pneumonia with pulmonary edema was made. After the patient failed to respond to treatment, bronchoscopy with tissue biopsy was performed for unresolving pneumonia. Histopathological results were consistent with pulmonary amyloidosis.
系统性淀粉样变累及肺部的影像学特征:典型病例
淀粉样变性是由异常不溶性蛋白在全身的病理性细胞外沉积引起的疾病[1]。肺淀粉样变性是一种局限于肺实质的淀粉样沉积形式,可引起气道阻塞、吞咽困难和慢性胸腔积液,通常具有非特异性的胸部影像学表现[1,2]。56岁男性,伴有轻链多发性骨髓瘤和系统性淀粉样变性,发热2天,无呼吸困难或咳嗽。进一步胸部影像学显示非特异性表现,包括实变、磨玻璃影、双上叶小叶间隔增厚和双侧胸腔积液;诊断为肺炎合并肺水肿。在患者对治疗无效后,对未解决的肺炎进行了支气管镜检查和组织活检。组织病理学结果与肺淀粉样变一致。
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