Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2023 Sep 20;48(3):91-94.
Nodular pulmonary amyloidosis, a subtype of pulmonary amyloidosis, is a unique disease that can mimic lung cancer on radiographic imaging and is related to lymphoproliferative disorders. In this report, we describe a case of a 76-year-old male who presented with a solitary nodule in his left lower lung lobe on computed tomography that increased from 6 mm to 13 mm in diameter over 40 months. Lung cancer was suspected; however, transbronchial lung biopsy revealed deposition of an eosinophilic and homogeneous amorphous substance, which showed apple-green birefringence under polarized light after Congo red staining, and immunohistochemistry analysis returned positive results for immunoglobulin lambda light-chain. Upper gastrointestinal endoscopy revealed a gastric mucosa-associated lymphoid tissue (MALT) lymphoma. These findings indicated that this was a case of nodular pulmonary amyloidosis that preceded a diagnosis of MALT lymphoma.
结节状肺淀粉样变性,是肺淀粉样变性的一个亚型,是一种独特的疾病,在影像学上可模拟肺癌,且与淋巴增生性疾病相关。本报告描述了一例 76 岁男性病例,其在 40 个月期间,胸部 CT 显示左下肺叶单发结节从 6 毫米增至 13 毫米,直径逐渐增大。最初怀疑为肺癌,但经支气管镜肺活检显示,有嗜酸性、均质无定形物质沉积,刚果红染色后偏振光下呈苹果绿双折射,免疫组化分析结果为免疫球蛋白 λ 轻链阳性。上消化道内镜显示胃黏膜相关淋巴组织(MALT)淋巴瘤。这些发现提示这是一例在 MALT 淋巴瘤之前出现的结节状肺淀粉样变性病例。