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酷似肺多发转移瘤:1例原发性结节性肺实质淀粉样变性病例并文献复习

Mimicking pulmonary multiple metastatic tumors: A case of primary nodular parenchymal pulmonary amyloidosis with review of the literature.

作者信息

Zhang Li-Na, Xue Xin-Ying, Wang Na, Wang Jian-Xin

机构信息

Department of Respiratory Diseases, Chinese PLA General Hospital, Beijing 100853, P.R. China.

出版信息

Oncol Lett. 2012 Dec;4(6):1366-1370. doi: 10.3892/ol.2012.923. Epub 2012 Sep 20.

Abstract

Primary pulmonary amyloidosis is a relatively rare condition, characterized by amyloid deposition in the lungs and other associated structures. We report a case of primary nodular parenchymal pulmonary amyloidosis in a 44-year-old male. The patient was referred to our hospital for further evaluation of multiple lobulated nodules in both lungs. As the multiple lung nodules were suspected to be metastatic, (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) was conducted, which revealed that the nodules had a mild uptake of (18)F-FCG. Amyloidosis was confirmed by conducting a percutaneous CT-guided fine-needle aspiration (FNA) biopsy in the left lung nodule. A literature review of previous studies on primary nodular parenchymal pulmonary amyloidosis from Medline (1970-October 2011) and Embase (1989-October 2011) was also included. Despite its rarity, primary nodular parenchymal pulmonary amyloidosis with a pattern of multiple nodules also forms part of the differential diagnosis of pulmonary metastases with high (18)F-FDG uptake on PET/CT.

摘要

原发性肺淀粉样变性是一种相对罕见的疾病,其特征是淀粉样物质沉积于肺及其他相关结构。我们报告一例44岁男性原发性结节性实质性肺淀粉样变性病例。该患者因双肺多发分叶状结节被转诊至我院进一步评估。由于怀疑这些多发肺结节为转移瘤,遂行(18)F-氟脱氧葡萄糖(FDG)正电子发射断层扫描/计算机断层扫描(PET/CT),结果显示这些结节对(18)F-FDG摄取轻度增高。通过对左肺结节进行CT引导下经皮细针穿刺抽吸(FNA)活检确诊为淀粉样变性。我们还对Medline(1970年至2011年10月)和Embase(1989年至2011年10月)上关于原发性结节性实质性肺淀粉样变性的既往研究进行了文献综述。尽管原发性结节性实质性肺淀粉样变性较为罕见,但具有多发结节表现的该疾病也构成PET/CT上FDG摄取增高的肺转移瘤鉴别诊断的一部分。

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