Luraine R, Sohier L, Kerjouan M, Desrues B, Delaval P, Jouneau S
Service de pneumologie, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
Rev Mal Respir. 2013 Sep;30(7):567-71. doi: 10.1016/j.rmr.2013.02.003. Epub 2013 Jul 8.
Light chain deposition disease is a rare clinical entity characterized by deposition of monoclonal immunoglobulin light chains in organs. The kidneys are almost always affected, while the lung manifestations that have been reported, including nodular or diffuse disease, especially cystic lesions, are unusual.
We report the case of a 60-year-old man with a diffuse infiltrative lung disease characterized by numerous apical cysts. The diagnosis of light chain deposition cystic lung disease was obtained by surgical lung biopsy. Light chain deposits in the salivary glands were the only extrapulmonary manifestation. Despite 12 chemotherapy cycles, the patient's lung function and radiological appearances worsened.
This is the fourth case describing a cystic lung disease due to light chain deposition in the literature. It highlights the need for comprehensive investigations so as not to miss this rare cause of cystic lung disease, which appears to be related to a primary pulmonary lymphoproliferative disorder. The only treatment that appears to be effective is lung transplantation.
轻链沉积病是一种罕见的临床病症,其特征为单克隆免疫球蛋白轻链在器官中沉积。肾脏几乎总会受到影响,而所报道的肺部表现,包括结节状或弥漫性病变,尤其是囊性病变,则较为少见。
我们报告一例60岁男性,患有以众多顶端囊肿为特征的弥漫性浸润性肺病。通过外科肺活检确诊为轻链沉积性囊性肺病。涎腺中的轻链沉积是唯一的肺外表现。尽管进行了12个化疗周期,患者的肺功能和影像学表现仍恶化。
这是文献中第四例描述由轻链沉积引起的囊性肺病的病例。它强调了进行全面检查的必要性,以免漏诊这种罕见的囊性肺病病因,其似乎与原发性肺淋巴增殖性疾病有关。唯一似乎有效的治疗方法是肺移植。