Sutani Akihisa, Tabe Kazuaki, Nagata Makoto, Kuramitsu Kaoru, Shimizu Yoshihiko, Sakamoto Yoshio
Department of Respiratory Medicine, Saitama Medical School.
Nihon Kokyuki Gakkai Zasshi. 2004 Sep;42(9):825-30.
Metastatic lung tumor was suspected in a 52-year-old woman who showed multiple nodules on her chest radiographs. Conventional examinations did not define the diagnosis, and so a biopsy was performed using video-assisted thoracoscopic surgery. Pathological examination demonstrated deposits of amorphous materials which were stained red by Congo red staining, even after potassium permanganate treatment. Green birefringence was also observed in the deposits under a polarized light microscope. A diagnosis of localized pulmonary amyloidosis with AL type amyloid protein was made, and therapy with dimethyl sulfoxide (10 ml/day) was started. During the two-year therapy, little exacerbation on pulmonary nodules was observed. It was suggested that dimethyl sulfoxide inhibited the progression of the disease.
一名52岁女性胸部X光片显示多个结节,怀疑患有转移性肺肿瘤。常规检查未能明确诊断,因此采用电视辅助胸腔镜手术进行活检。病理检查显示有无定形物质沉积,即使经过高锰酸钾处理,刚果红染色仍将其染成红色。在偏振光显微镜下,沉积物中也观察到绿色双折射。诊断为局限性肺淀粉样变性伴AL型淀粉样蛋白,并开始用二甲基亚砜(10毫升/天)治疗。在两年的治疗期间,肺部结节几乎没有加重。提示二甲基亚砜抑制了疾病的进展。