Barešić M, Sreter K B, Brčić L, Hećimović A, Janevski Z, Anić B
Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University of Zagreb, School of Medicine, University Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
Department of Clinical Immunology, Pulmonology, and Rheumatology, University Hospital Centre "Sestre Milosrdnice", Vinogradska cesta 17, 10000 Zagreb.
Lupus. 2015 Dec;24(14):1546-51. doi: 10.1177/0961203315591025. Epub 2015 Jun 17.
Localized amyloid deposits (tumoral amyloidosis or amyloidoma) are uncommon form of amyloidosis and nodular pulmonary amyloidomas are rarely found. This incidental finding can mimic a bronchopulmonary neoplasm and may occur secondarily to an infectious, inflammatory or lymphoproliferative disease. We report a case of a 62-year-old female with long-standing systemic lupus erythematosus (SLE) with low compliance who presented with radiologically-verified solitary pulmonary nodule. Work-up included positron emission tomography-computed tomography (PET-CT) scan, which revealed hypermetabolic uptake of (18)F-fluorodeoxyglucose, and lobectomy was performed. Staining of the tissue was positive for Congo red and was green birefringent under polarized light. Immunohistochemical methods excluded lymphoproliferative disease and confirmed amyloidoma. SLE was controlled with antimalarials and glucocorticoids. Pulmonary amyloidoma should be considered in the differential diagnosis of solitary lung nodules.
局限性淀粉样沉积(肿瘤性淀粉样变性或淀粉样瘤)是淀粉样变性的一种罕见形式,结节性肺淀粉样瘤则更为罕见。这一偶然发现可能会被误诊为支气管肺肿瘤,并且可能继发于感染性、炎症性或淋巴增殖性疾病。我们报告一例62岁女性,患有长期系统性红斑狼疮(SLE)且依从性差,出现经放射学证实的孤立性肺结节。检查包括正电子发射断层扫描-计算机断层扫描(PET-CT),显示(18)F-氟脱氧葡萄糖摄取增加,随后进行了肺叶切除术。组织刚果红染色阳性,在偏振光下呈绿色双折射。免疫组化方法排除了淋巴增殖性疾病,确诊为淀粉样瘤。通过抗疟药和糖皮质激素控制SLE。在孤立性肺结节的鉴别诊断中应考虑肺淀粉样瘤。