Chest
Clinical InvestigationsAmyloidosis of the Lower Respiratory Tract: Clinical and Pathologic Features in a Series of 21 Patients
Section snippets
MATERIALS AND METHODS
We studied all patients with amyloidosis seen in bronchopulmonary specimens examined by our Pathology Department between 1970 and 1985 and for whom sufficient clinical details were available. Amyloidosis was diagnosed on seeing typical amorphous eosinophilic extracellular material with a green birefringence under the polarizing microscope after staining with Congo red. Sections were also pre-treated with potassium permanganate (except for cases 4,6,9,12,14). This abolishes the uptake of Congo
RESULTS
Our series included 21 patients (14 men and 7 women), with a mean age of 59.8 years (range 35–90). They were classified as follows: tracheobronchial amyloidosis: multifocal submucosal plaques, three; pseudotumor mass, two (one associated with nodular parenchymal amyloidosis). Parenchymal amyloidosis: nodular, two; diffuse, 15. Pretreatment with potassium permanganate did not abolish the uptake of Congo red in any of the sections tested.
DISCUSSION
The varied pattern of involvement of the lower respiratory tract by amyloidosis gives rise to several different clinical and radiologic presentations.3, 5, 6, 7 Our three patients with multifocal submucosal amyloid plaques had atelectasis. Bronchial biopsy led quickly to the diagnosis. In one of these patients, ossification associated with the amyloid deposits suggested a relationship between amyloidosis and tracheobronchopathia osteoplastica.3 Tracheobronchial amyloidosis is an indolent form
ACKNOWLEDGMENTS
We thank our colleagues who contributed to this study: Prs J. C. Bertrand, J. Normand, R. Tête, P. Touboul; Drs. H. Benier, P. Chapuy, M. Gauthier, A. Gressard, B. Saugier, M. Silie, L. Van Straaten, J. M. Vergnon, B. Veyre, M. Vincent and S. Peyrol. We also thank L. D. Gruer for reviewing the translation and M. C. Thévenet for secretarial assistance.
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2021, Radiology Case ReportsCitation Excerpt :Amyloidosis can be systemic or localized in one organ with little or no spread, with very different prognosis and treatment implications. It is estimated that about 50% of amyloidosis cases are localized in the respiratory system and are categorized in 3 forms: (1) tracheobronchial amyloidosis, (2) nodular parenchymal amyloidosis, and (3) diffuse parenchymal or alveolar septal amyloidosis [1-6]. The diagnosis of respiratory amyloidosis is challenging and often missed since the clinical symptoms, when present, are non-specific and extremely common.
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Manuscript received April 14; revision accepted July 1.